Relation Between Ascending Aortic Pressures and Outcomes in Patients With Angiographically Demonstrated Coronary Artery Disease

• Published in: The American journal of cardiology Vol. 96; no. 5; pp. 645 - 648
• Main Authors: Chirinos, Julio A., Zambrano, Juan P., Chakko, Simon, Veerani, Anila, Schob, Alan, Perez, Guido, Mendez, Armando J.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.09.2005; Elsevier; Elsevier Limited
• Subjects: Aorta - physiopathology; Biological and medical sciences; Blood pressure; Blood Pressure - physiology; Cardiac Catheterization; Cardiology. Vascular system; Cardiovascular disease; Coronary Angiography; Coronary Disease - diagnostic imaging; Coronary Disease - physiopathology; Coronary heart disease; Coronary vessels; Follow-Up Studies; Heart; Humans; Male; Medical sciences; Middle Aged; Outcome Assessment (Health Care); Predictive Value of Tests; Prospective Studies; Risk Factors; Human; Prognosis; Cardiovascular disease; Aorta; Evolution; Circulatory system; Cardiology; Coronary heart disease; Phlebology; Pressure
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2005.04.036

We prospectively followed 324 men, who underwent coronary angiography, for 1,161 ± 418 days. We analyzed the association between ascending aortic pressures measured during cardiac catheterization and the risk of all-cause mortality and a combined end point of major adverse cardiovascular events (MACEs), including unstable angina pectoris, myocardial infarction, coronary revascularization, stroke, or death. Pulse pressure significantly predicted MACEs (hazard ratio [HR] per 10 mm Hg increase 1.09, 95% confidence interval [CI] 1.002 to 1.17, p = 0.04). Diastolic blood pressure (BP) inversely correlated with the risk of MACEs (HR per 10 mm Hg increase 0.85, 95% CI 0.74 to 0.98, p = 0.02). These correlations remained significant after adjusting for other predictors and potential confounders. The association between lower diastolic BP with the risk of MACEs was more pronounced in patients with triple-vessel coronary artery disease (p for interaction = 0.03). Peripheral diastolic BP (but not pulse pressure) correlated inversely with the risk of MACEs (HR 0.87 per 10 mm Hg increase, 95% CI 0.75 to 0.998, p = 0.047). Aortic pulse pressure significantly predicted death (HR per 10 mm Hg increase 1.18, 95% CI 1.05 to 1.33, p = 0.004), and aortic diastolic BP correlated inversely with the risk of death (HR 0.76, 95% CI 0.62 to 0.94, p = 0.01).