Impact of pre-procedural diastolic blood pressure on long-term cardiac death of NSTEMI patients following percutaneous coronary intervention

Abstract

Abstract Aims Diastolic blood pressure(DBP) is associated with cardiovascular outcomes particularly in the presence of coronary artery disease (CAD). However, the relationship between DBP and long-term cardiac death in Non-ST-segment elevation myocardial infarction (NSTEMI) patients is still unclear. We aimed to evaluate the relationship between pre-procedural DBP and long-term cardiac death of NSTEMI patients following percutaneous coronary intervention (PCI).Methods The study data were obtained from Dryad data repository. In our primary analyses, we include the cases of NSTEMI (1486 patients) who were treated with at least one drug-eluting stent and completed long-term follow-up documentation.Results High pre-procedural DBP was identified as a significant and independent risk factor of long-term cardiac death. A 1mm Hg increase in pre-procedural DBP level was associated with a 11% higher risk of long-term cardiac death ( 95% CI: 1.05 to 1.17; P<0.0001). Nonlinearity analysis showed that the infection point of DBP at 92 mm Hg and the statistical correlation only existed to the right of the infection point .The impact size and 95% CI were 1.19 and 1.08-1.30 (P=0.0004), respectively. Conclusion Higher pre-procedural DBP was a risk factor of long-term cardiac death of NSTEMI patients following PCI, and the infection point is 92 mm Hg.