Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
Cardiac Emergency Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China.
BMC Cardiovasc Disord. 2021 Dec 30;21(1):623. doi: 10.1186/s12872-021-02435-2.
There is no clear evidence for the target value of blood pressure control after Percutaneous coronary intervention (PCI). Therefore, our study was designed to explore the relationship between blood pressure after PCI and major adverse cardiac events (MACE) during 3-year follow-up.
This study is a prospective study. We included the patients who were diagnosed with acute coronary syndrome and underwent PCI stent implantation operation. The study initially collected information of 552 patients. The start and end times of the study are from January 1, 2017 to December 31, 2020. The independent variables of this study are the average systolic blood pressure and the average diastolic blood pressure after PCI. The dependent variable is the occurrence of MACE events in patients within 3 years after PCI. MACE is defined as acute myocardial infarction, recurring chest pain, heart failure, stroke, revascularization and cardiac death.
A total of 514 subjects met the inclusion criteria. The average age of the study subjects is 61.92 ± 9.49 years old, of which 67.12% are male. 94 subjects had a MACE event within 3 years, and the occurrence rate was 18.29%. There is no significant non-linear or linear relationship between diastolic blood pressure and MACE events. There is a curvilinear relationship between the average systolic blood pressure of patients after PCI and MACE events within 3 years and the inflection point is 121. On the left side of the inflection point, the effect size and 95% CI are 1.09 and 1.01-1.18, respectively (P = 0.029). The impact size and 95% CI at the right inflection point were 1.00 and 0.98-1.02(P = 0.604), respectively.
There is a curvilinear relationship between systolic blood pressure and prognosis of patients after PCI. Under the premise of ensuring the safety of patients, maintaining lower blood pressure after surgery is beneficial to improve the prognosis of patients.
经皮冠状动脉介入治疗（PCI）后血压控制的目标值尚缺乏明确证据。因此，本研究旨在探讨 PCI 后血压与 3 年随访期间主要不良心脏事件（MACE）的关系。
这是一项前瞻性研究。我们纳入了诊断为急性冠状动脉综合征并接受 PCI 支架植入术的患者。该研究最初收集了 552 例患者的信息。研究的开始和结束时间为 2017 年 1 月 1 日至 2020 年 12 月 31 日。本研究的自变量是 PCI 后平均收缩压和平均舒张压。因变量是 PCI 后 3 年内患者发生 MACE 事件的情况。MACE 定义为急性心肌梗死、胸痛再发、心力衰竭、卒中和血运重建及心脏性死亡。
共 514 例患者符合纳入标准。研究对象的平均年龄为 61.92±9.49 岁，其中 67.12%为男性。94 例患者在 3 年内发生 MACE 事件，发生率为 18.29%。舒张压与 MACE 事件之间无明显的非线性或线性关系。PCI 后患者平均收缩压与 3 年内 MACE 事件之间存在曲线关系，拐点为 121。在拐点左侧，效应量和 95%CI 分别为 1.09 和 1.01-1.18（P=0.029）。在拐点右侧，效应量和 95%CI 分别为 1.00 和 0.98-1.02（P=0.604）。
收缩压与 PCI 后患者的预后呈曲线关系。在保证患者安全的前提下，术后维持较低的血压有利于改善患者的预后。
