Abstract
BackgroundAlthough the inter-arm blood pressure (BP) difference has been advocated to be associated with cardiovascular events, the implication of inter-leg BP difference has not been well established. This study was conducted to investigate whether inter-arm and -leg BP differences have prognostic value in patients undergoing percutaneous coronary intervention (PCI).MethodsIn this prospective study, we consecutively enrolled 667 patients who underwent PCI. Both arm and leg BPs were measured at the day after PCI. The primary outcome was a major adverse cardiovascular event (MACE) including cardiac death, acute coronary syndrome, coronary revascularization, stroke, and hospitalization for heart failure during the follow-up period.ResultsMean age was 64.0±11.1 years old, and males were predominant (70.5%). During a mean follow-up period of 3.0 years, MACE occurred in 209 (31.3%) patients. The inter-leg systolic BP difference (ILSBPD) was significantly higher in patients with MACE than those without (9.9±12.3 vs. 7.2±7.5 mmHg, P = 0.004). The inter-arm systolic BP difference was not significantly different between patients with and without MACE (P = 0.403). In multivariable Cox regression analysis, increased ILSBPD was independently associated with the development of MACE (per 5 mmHg; hazard ratio, 1.07; 95% confidence interval, 1.01–1.14). The inter-arm systolic BP difference was not associated with MACE in the multivariable analysis.ConclusionIncreased ILSBPD was independently associated with worse cardiovascular outcomes after PCI. As ILSBPD is easy to measure, it may be helpful in the risk stratification of patients undergoing PCI.
Highlights
The burden of cardiovascular (CV) disease continues to rise, and it has become the leading cause of death worldwide [1]
In multivariable Cox regression analysis, increased inter-leg systolic BP difference (ILSBPD) was independently associated with the development of major adverse cardiovascular event (MACE)
Increased ILSBPD was independently associated with worse cardiovascular outcomes after percutaneous coronary intervention (PCI)
Summary
The burden of cardiovascular (CV) disease continues to rise, and it has become the leading cause of death worldwide [1]. After recognition of the prevalence and clinical implication of inter-arm systolic BP difference (IASBPD) [5,6], there has been growing evidence for the prognostic capability of IASBPD. Data on the clinical implication of inter-leg BP difference has been limited. A few studies have reported that inter-leg systolic BP difference (ILSBPD) is associated with PAD [12], stroke [13], and mortality [14,15]. The inter-arm blood pressure (BP) difference has been advocated to be associated with cardiovascular events, the implication of inter-leg BP difference has not been well established. This study was conducted to investigate whether inter-arm and -leg BP differences have prognostic value in patients undergoing percutaneous coronary intervention (PCI)
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