21 SYSTOLIC BLOOD PRESSURE VARIABILITY AS PREDICTOR OF ADVERSE OUTCOMES IN PATIENTS UNDERWENT MYOCARDIAL REVASCULARIZATION: A SYSTEMATIC REVIEW AND META-ANALYSIS

Abstract

Background: Coronary Arterial Disease (CAD) has large morbidity and mortality burden, becoming the leading cause of death worldwide. High Systolic Blood Pressure (SBP) Variability has been associated with increased cardiovascular disease risk. However, the evidence of its impact on myocardial revascularization outcome is still lacking. Objective: This study aimed to investigate the SBP variability prognostic value in patients who received myocardial revascularization. Method: Literature search was conducted on PubMed, EMBASE, Cochrane Library, Google Scholar, and ProQuest. The outcomes were all-cause mortality and major adverse cardiovascular events (MACEs). Result: Five cohort studies involving a total of 11,214 patients received myocardial revascularization were included, of which three studies reported data in Percutaneous Coronary Intervention (PCI) and two studies analyze the outcome on Coronary Arterial Bypass Grafting (CABG). On pooled analysis of PCI group, elevated SBP variability significantly associated with higher all-cause mortality (Hazard ratio [HR] 1.63; 95% confidence interval [CI] 1.34—1.98; p < 0.0001; I2 = 0%) and increased MACEs (Hazard ratio [HR] 1.38; 95% confidence interval [CI] 1.19—1.62; p < 0.0001; I2 = 12%). On pooled analysis of CABG group, increased SBP variability have non-significant association with higher mortality (Hazard ratio [HR] 1.29; 95% confidence interval [CI] 0.85—1.94; p <=0.24; I2 = 85%) Conclusion: Increased SBP variability was significantly associated with higher all-cause mortality and MACEs in patients undergoing PCI, but its association is insignificant to all-cause mortality in patients who received CABG.