PCI术后高血压患者血压变异性与心血管事件的关系

Association between variability in blood pressure and cardiovascular events in hypertensive patients after successful percutaneous coronary intervention

目的:研究PCI术后高血压患者血压变异度(VVV)与心血管事件的关系。方法:入选160例成功PCI术后的高血压患者,分成急性冠脉综合征(ACS)组(80例)和稳定型心绞痛(SAP)组(80例)。于第1、2、3、6个月进行临床随访,共进行4次直到第6个月复查冠状动脉(冠脉)造影。每次随访行24h动态血压监测,记录主要心血管不良事件(心肌梗死、靶目标血运重建和全因死亡)。结果:2组患者血压均值、最大值、最小值及VVV都没有显著的统计学差异。ACS组再发心肌梗死患者收缩压VVV、收缩压最大值明显高于非心肌梗死患者。ROC曲线显示,ACS组中心肌梗死患者最佳敏感度、特异度时收缩压VVV、收缩压最大值的切点分别是15.4mmHg和138.0mmHg。结论:高血压合并ACS患者成功PCI后较高的收缩压VVV和最大值与再发心肌梗死相关。

Objective：To investigate the associations between visit-to-visit variability（VVV）in blood pressure and cardiovascular events in patients with hypertension after successful percutaneous coronary intervention（PCI）.Method：Atotal of 160 hypertensive patients who had undergone successful PCI were included and divided into acute coronary syndrome group（ACS group,n=80）and stable angina pectoris group（SAP group,n=80）.The patientshad four clinic visits at 1th,2th,3thand6 th month after PCI until underwent coronary angiography（CAG）.Twenty-four hours ambulatory blood pressure was measured,and the major adverse cardiovascular events（MACEs）were also analyzed during follow-up.Result：There were no significant differences in VVV,average or maximum or minimum blood pressure between the two groups.In the ACS group,VVV and maximum systolic pressure in patients with myocardial infarction were significantly higher than those without MI.The cut-off levels for VVV in blood pressure and maximum systolic pressure that gave the greatest sensitivity and specificity for MI in the ACS group were 15.4and 138.0 mmHg,respectively.Conclusion：Higher VVV in systolic pressure and maximum systolic pressure in patients with ACS after successful PCI are associated with the onset of myocardial infarction.