Aortic pulse pressure and extent of coronary artery disease in percutaneous transluminal coronary angioplasty candidates

Background: Pulse pressure and aortic stiffness are both predictors of coronary artery disease. Whether these parameters are directly related to coronary structural alterations has never been studied. Methods: From September 1999 to September 2000, the following data were collected from 99 eligible patients: invasive intra-aortic systolic and diastolic blood pressures (BP), extent of coronary artery disease, cardiovascular risk factors, and the incidence of angiographically documented restenosis after coronary angioplasty. Results: In the study population, independent determinants of aortic pulse pressure were age, gender, aortic mean BP, heart rate, and extent of coronary artery disease (r(2) =0.57, P <.0001). In univariate analysis, invasive aortic, but not noninvasive brachial, mean pressure (P =.017) and pulse pressure (P =.027) were significantly associated to the extent of coronary artery disease. In a multiple regression analysis, only male gender (P =.013) and the level of aortic pulse pressure (P =.023) were independently associated with the extent of coronary heart disease. Restenosis was angiographically documented in 11 patients (11%). There was a borderline significant association of restenosis to aortic mean BP (P =.05) and to a past history of multiple previous angioplasties (P = .03). Conclusions: In this study, 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 BP in the stent era.