Changes in systolic blood pressure during hospitalisation and bleeding events after percutaneous coronary intervention

被引：0

作者：

Otsuka, Yasuhiro ^{[1
]}

Ishii, Masanobu ^{[2
]}

Ikebe, So ^{[3
]}

Nakamura, Taishi ^{[3
,4
]}

Tsujita, Kenichi ^{[5
]}

Matoba, Tetsuya ^{[6
]}

Kohro, Takahide ^{[7
]}

Oba, Yusuke ^{[8
]}

Kabutoya, Tomoyuki ^{[9
]}

Kario, Kazuomi ^{[10
]}

Imai, Yasushi ^{[11
]}

Kiyosue, Arihiro ^{[12
,13
]}

Mizuno, Yoshiko ^{[14
,15
]}

Nochioka, Kotaro ^{[16
]}

Nakayama, Masaharu ^{[17
]}

Iwai, Takamasa ^{[18
]}

Miyamoto, Yoshihiro ^{[19
]}

Sato, Hisahiko ^{[20
]}

Akashi, Naoyuki ^{[21
]}

Fujita, Hideo ^{[22
]}

Nagai, Ryozo ^{[23
]}

机构：

[1] Kumamoto Univ Hosp, Dept Cardiovasc Med, Kumamoto, Japan

[2] Kumamoto Univ, Kumamoto, Japan

[3] Kumamoto Univ, Dept Cardiovasc Med, Kumamoto, Japan

[4] Kumamoto Univ, Grad Sch Med Sci, Kumamoto, Japan

[5] Kumamoto Univ, Cardiovasc Med, Kumamoto, Japan

[6] Kyushu Univ, Dept Cardiovasc Med, Fukuoka, Japan

[7] Jichi Med Univ, Clin Informat, Shimotsuke, Tochigi, Japan

[8] Jichi Med Univ, Sch Med, Dept Med, Div Cardiovasc Med, Shimotsuke, Japan

[9] Jichi Med Univ, Sch Med, Shimotsuke, Japan

[10] Jichi Med Univ, Div Cardiovasc Med, Sch Med, Shimotsuke, Tochigi, Japan

[11] Jichi Med Univ, Dept Pediat, Shimotsuke 3290498, Japan

[12] Univ Tokyo Hosp, Dept Cardiovasc Med, Bunkyo ku, Tokyo, Japan

[13] Moriyama Mem Hosp, Cadiovasc Ctr, Edogawa ku, Tokyo, Japan

[14] Univ Tokyo Hosp, Dept Cardiovasc Med, Bunkyo ku, Tokyo, Japan

[15] Dev Bank Japan Inc, Tokyo, Japan

[16] Tohoku Univ Hosp, Dept Cardiovasc Med, Sendai, Japan

[17] Tohoku Univ, Grad Sch Med, Grad Sch Med, Sendai, Japan

[18] Natl Cerebral & Cardiovasc Ctr, Dept Cardiovasc Med, Suita, Japan

[19] Natl Cerebral & Cardiovasc Ctr, Suita, Osaka, Japan

[20] Tokyo Inst Technol, Tokyo, Japan

[21] Jichi Med Univ, Saitama Med Ctr, Ophthalmol, Omiya, Japan

[22] Saitama Med Ctr, Kawagoe, Saitama, Japan

[23] Jichi Med Univ, Shimotsuke, Japan

来源：

OPEN HEART | 2024年 / 11卷 / 02期

关键词：

Hypertension; Coronary Stenosis; Angina Pectoris; DUAL ANTIPLATELET THERAPY; RISK SCORE; OUTCOMES; DISEASE; LEVEL; PCI;

D O I：

10.1136/openhrt-2024-002987

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background Hypertension is a risk factor for bleeding events and is included in the HAS-BLED (Hypertension, Abnormal renal/liver function, Stroke, Bleeding history or predisposition, Labile INR, Elderly, Drugs/Alcohol concomitantly) score. However, the effects of blood pressure (BP) and changes in BP on bleeding events in patients undergoing percutaneous coronary intervention (PCI) remain poorly understood. This study is aimed to investigate the relationship between systolic BP (SBP) changes during hospitalisation and bleeding events in patients undergoing PCI. Methods From the Clinical Deep Data Accumulation System database, a multicentre database encompassing seven tertiary medical hospitals in Japan that includes data for patient characteristics, medications, laboratory tests, physiological tests, cardiac catheterisation and PCI treatment, data for 6351 patients undergoing PCI between April 2013 and March 2019 were obtained. The study population was categorised into three groups based on the changes in SBP during hospitalisation: (1) elevated BP (>= 20 mm Hg), (2) no change (>=-20 to <20 mm Hg) and (3) decreased BP (<-20 mm Hg) groups. The primary outcome was a 3-year major bleeding event defined as moderate or severe bleeding according to the Global Use of Streptokinase and t-PA for Occluded Coronary Arteries bleeding criteria. Results The elevated BP group exhibited significantly lower SBP at admission and higher SBP at discharge (p<0.001). Multivariable Cox hazard regression models showed that elevated BP was associated with a high risk of bleeding events (HR: 1.885; 95% CI, 1.294 to 2.748). The multivariable logistic regression model identified female sex, chronic coronary syndrome, peripheral artery disease and chronic kidney disease as independent factors associated with elevated BP. Conclusions These findings suggest that BP management is essential to prevent bleeding events after PCI.

引用

页数：8

共 30 条

[1] Sex Differences in Long-Term Outcomes in Patients With Chronic Coronary Syndrome After Percutaneous Coronary Intervention [J].

Akashi, Naoyuki ;

Matoba, Tetsuya ;

Kohro, Takahide ;

Oba, Yusuke ;

Kabutoya, Tomoyuki ;

Imai, Yasushi ;

Kario, Kazuomi ;

Kiyosue, Arihiro ;

Mizuno, Yoshiko ;

Nochioka, Kotaro ;

Nakayama, Masaharu ;

Iwai, Takamasa ;

Miyamoto, Yoshihiro ;

Ishii, Masanobu ;

Nakamura, Taishi ;

Tsujita, Kenichi ;

Sato, Hisahiko ;

Fujita, Hideo ;

Nagai, Ryozo ;

CLIDAS Res Grp .

CIRCULATION JOURNAL, 2023, 87 (06) :775-782

[2] Hyperuricemia predicts increased cardiovascular events in patients with chronic coronary syndrome after percutaneous coronary intervention: A nationwide cohort study from Japan [J].

Akashi, Naoyuki ;

Kuwabara, Masanari ;

Matoba, Tetsuya ;

Kohro, Takahide ;

Oba, Yusuke ;

Kabutoya, Tomoyuki ;

Imai, Yasushi ;

Kario, Kazuomi ;

Kiyosue, Arihiro ;

Mizuno, Yoshiko ;

Nochioka, Kotaro ;

Nakayama, Masaharu ;

Iwai, Takamasa ;

Nakao, Yoko ;

Iwanaga, Yoshitaka ;

Miyamoto, Yoshihiro ;

Ishii, Masanobu ;

Nakamura, Taishi ;

Tsujita, Kenichi ;

Sato, Hisahiko ;

Fujita, Hideo ;

Nagai, Ryozo .

FRONTIERS IN CARDIOVASCULAR MEDICINE, 2023, 9

[3]

Araki E, 2020, DIABETOL INT, V11, P165, DOI [10.1007/s13340-020-00439-5, 10.1111/jdi.13306]

[4] REGULATION OF CEREBRAL BLOOD FLOWIN HUMANS: PHYSIOLOGY AND CLINICAL IMPLICATIONS OF AUTOREGULATION [J].

Claassen, Jurgen A. H. R. ;

Thijssen, Dick H. J. ;

Panerai, Ronney B. ;

Faraci, Frank M. .

PHYSIOLOGICAL REVIEWS, 2021, 101 (04) :1487-1559

[5] Risk score to predict serious bleeding in stable outpatients with or at risk of atherothrombosis [J].

Ducrocq, Gregory ;

Wallace, Joshua S. ;

Baron, Gabriel ;

Ravaud, Philippe ;

Alberts, Mark J. ;

Wilson, Peter W. F. ;

Ohman, Erik Magnus ;

Brennan, Danielle M. ;

D'Agostino, Ralph B. ;

Bhatt, Deepak L. ;

Steg, Philippe Gabriel .

EUROPEAN HEART JOURNAL, 2010, 31 (10) :1257-1265

[6] Impact of heart failure severity and major bleeding events after percutaneous coronary intervention on subsequent major adverse cardiac events [J].

Ikebe, So ;

Ishii, Masanobu ;

Otsuka, Yasuhiro ;

Nakamura, Taishi ;

Tsujita, Kenichi ;

Matoba, Tetsuya ;

Kohro, Takahide ;

Oba, Yusuke ;

Kabutoya, Tomoyuki ;

Imai, Yasushi ;

Kario, Kazuomi ;

Kiyosue, Arihiro ;

Mizuno, Yoshiko ;

Nochioka, Kotaro ;

Nakayama, Masaharu ;

Iwai, Takamasa ;

Miyamoto, Yoshihiro ;

Sato, Hisahiko ;

Akashi, Naoyuki ;

Fujita, Hideo ;

Nagai, Ryozo .

INTERNATIONAL JOURNAL OF CARDIOLOGY CARDIOVASCULAR RISK AND PREVENTION, 2023, 18

[7]

Japan nephrology society, 2012, Nihon Jinzo Gakkai Shi, V54, P1034

[8] Bleeding and Subsequent Cardiovascular Events and Death in Atrial Fibrillation With Stable Coronary Artery Disease [J].

Kaikita, Koichi ;

Yasuda, Satoshi ;

Akao, Masaharu ;

Ako, Junya ;

Matoba, Tetsuya ;

Nakamura, Masato ;

Miyauchi, Katsumi ;

Hagiwara, Nobuhisa ;

Kimura, Kazuo ;

Hirayama, Atsushi ;

Matsui, Kunihiko ;

Ogawa, Hisao .

CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2021, 14 (11) :E010476

[9] Recommendations for Cardiac Chamber Quantification by Echocardiography in Adults: An Update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging [J].

Lang, Roberto M. ;

Badano, Luigi P. ;

Mor-Avi, Victor ;

Afilalo, Jonathan ;

Armstrong, Anderson ;

Ernande, Laura ;

Flachskampf, Frank A. ;

Foster, Elyse ;

Goldstein, Steven A. ;

Kuznetsova, Tatiana ;

Lancellotti, Patrizio ;

Muraru, Denisa ;

Picard, Michael H. ;

Rietzschel, Ernst R. ;

Rudski, Lawrence ;

Spencer, Kirk T. ;

Tsang, Wendy ;

Voigt, Jens-Uwe .

JOURNAL OF THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY, 2015, 28 (01) :1-U170

[10] Blood pressure and cardiovascular disease in the Asia Pacific region [J].

Lawes, CMM ;

Rodgers, A ;

Bennett, DA ;

Parag, V ;

Suh, I ;

Ueshima, H ;

MacMahon, S .

JOURNAL OF HYPERTENSION, 2003, 21 (04) :707-716

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