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Aortic Pulse Pressure May Predict Extent Of Coronary Artery Disease
A DGReview of :"Aortic pulse pressure and extent of coronary artery disease in percutaneous transluminal coronary angioplasty candidates"
American Journal of Hypertension
08/29/2002
By Andrew A. Skolnick
The aortic pulse pressure of coronary angioplasty candidates may predict the extent of the patient's coronary artery disease.
Pulse pressure and aortic stiffness are both predictors of coronary artery disease. Whether these parameters are directly related to coronary structural abnormalities, however, has not previously been determined.
Francois Philippe at the Institut Mutualiste Montsouris, in Paris, France, and colleagues collected clinical data from 99 candidates for percutaneous transluminal coronary angioplasty.
The data included invasive intra-aortic systolic and diastolic blood pressures, the extent of coronary artery disease, the incidence of angiographically documented restenosis after coronary angioplasty, and other cardiovascular risk factors.
The researchers found that age, gender, aortic mean blood pressure, heart rate, and the extent of coronary artery disease were all independent determinants of aortic pulse pressure in these patients.
Univariate analysis showed that aortic mean pressure and pulse pressure were significantly associated with the extent of coronary artery disease, however mean noninvasive brachial blood pressure and pulse pressure were not.
In a multiple regression analysis, only male gender and the level of aortic pulse pressure were independently associated with the extent of coronary heart disease, the investigators reported.
Restenosis was angiographically documented in 11 patients. The investigators noted a borderline significant association of restenosis with aortic mean blood pressure (P = .05) and with a history of multiple previous angioplasties (P = .03).
The researchers concluded, "aortic pulse pressure was a significant risk factor for the extent of coronary artery disease. There was only a borderline significant association of restenosis to the steady, but not pulsatile, component of aortic blood pressure in the stent era."
Am J Hypertens 2002; 15: 672-677
"Aortic pulse pressure and extent of coronary artery disease in percutaneous transluminal coronary angioplasty candidates"
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