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|Title:||Impact of pre-procedural diastolic blood pressure on outcomes in patients undergoing percutaneous coronary intervention.|
|Conference Name:||68th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 14th Annual Australia and New Zealand Endovascular Therapies Meeting|
|Conference Date:||December 11-13|
|Abstract:||Introduction: Aggressive lowering of diastolic blood pressure (DBP) can occur at the expense of myocardial perfusion, particularly in the presence of coronary artery disease (CAD). Methods: We analysed data from 12,965 consecutive patients undergoing percutaneous coronary intervention (PCI) between 2009 and 2018 from the Melbourne Interventional Group registry who had pre-procedural systolic blood pressure (SBP) <140 mmHg. Patients with ST-elevation myocardial infarction, cardiogenic shock and out-of-hospital arrest were excluded. Patients were stratified into four groups according to DBP: <70 mmHg, 70-79 mmHg, 80-89 mmHg and >89 mmHg. Mortality data were derived from the National Death Index. Results: Patients with DBP <70 mmHg were older, were more likely to be women, have diabetes, renal impairment, prior myocardial infarction, left ventricular dysfunction, multi-vessel disease, peripheral and cerebrovascular disease (all p<0.001). There was no difference in in-hospital or 30-day major adverse cardiovascular events, but patients with DBP <70 mmHg had lower long-term survival on NDI-linkage (Figure). However, on multivariable analysis, DBP <70 mmHg was not an independent predictor of mortality (HR 1.0, 95% CI 0.86-1.15). Conclusions: In patients with well controlled SBP undergoing PCI, lower DBP is associated with higher long-term mortality, related to a greater burden of co-morbidities and higher risk profile.|
|Internal ID Number:||01643|
|Health Subject:||PERCUTANEOUS CORONARY INTERVENTION|
|Appears in Collections:||Research Output|
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