Correlation Between Short-Term Blood Pressure Variability After Primary Percutaneous Coronary Intervention and Adverse Cardiovascular Events in Patients With ST Segment Elevation Myocardial Infarction

Abstract

Abstract Background To investigate the relationship between short-term blood pressure variability (BPV) after primary percutaneous coronary intervention (PPCI) and adverse cardiovascular outcomes 1 year after operation in patients with acute ST segment elevation myocardial infarction (STEMI). Methods The clinical and prognostic data of 331 patients with STEMI who underwent PPCI and drug-eluting stent implantation were collected retrospectively from 2016 to 2019. The correlation between BPV within 4 days and adverse cardiovascular outcome 1 year after operation was analyzed. Blood pressure SD was used to evaluate individual systolic blood pressure variability (SBPV) and diastolic blood pressure variability (DBPV). The high SBPV and DBPV groups were defined as SD ≥11.42 and ≥8.49 mm Hg, respectively. Multivariate bivariate logistic regression model was used to explore the correlation between SBPV, DBPV, and major adverse cardiovascular events (MACE) 1 year after operation. Results The incidence of heart failure in the high SBPV group (21.1% vs. 10.3%) was significantly higher than the low SBPV group. Also, the incidence of heart failure (23.5% vs. 7.9%) and the cumulative incidence of MACE (29.5% vs. 13.9%) in the high DBPV group were higher than those in the low DBPV group (all P < 0.05). After adjusting for age, sex, body mass index, antihypertensive drugs, left ventricular ejection fraction, Gensini score, and other influencing factors, multivariate binary logistic regression analysis showed that high SBPV was a risk factor for heart failure (odds ratio [OR] = 3.462, 95% confidence interval [CI] 1.476–8.117, P = 0.004), and high DBPV was a risk factor for heart failure and cumulative MACE (OR = 4.535, 95% CI 1.725–11.926, P = 0.002; OR = 3.412, 95% CI 1.627–7.152, P = 0.001, respectively) and in the subgroup hypertensives using oral antihypertensive drugs (OR = 4.328, 95% CI 1.619–11.572, P = 0.004), as well as high DBPV for heart failure and cumulative MACE (OR = 4.600, 95% CI 1.518–13.934, P = 0.007; OR = 4.942, 95% CI 1.851–13.198, P = 0.001, respectively). Conclusions High BPV within 4 days after PPCI and drug-eluting stent implantation in STEMI patients is a cardiovascular risk factor within 1 year after operation.