12.24 Coronary Intrastent Restenosis and Blood Pressure Levels: Retrospective Analysis of a Large Cohort of Patients wit
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High Blood Press Cardiovasc Prev 2008; 15 (3): 171-215 1120-9879/08/0003-0171/$48.00/0 © 2008 Adis Data Information BV. All rights reserved.
Vessels and Endothelium 12.24 Coronary Intrastent Restenosis and Blood Pressure Levels: Retrospective Analysis of a Large Cohort of Patients with Coronary Single Vessel Disease G. Tocci (1), R. Coluccia (1), A. Modestino (1), S. Sciarretta (1), F. Paneni (1), D.M. Zardi (1), B.A. Pace (1), C. Nannini (1), S. Abbolito (1), G. Sorropaco (2), A. Ferrucci (1), A. Berni (1), P. Rubino (2), M. Volpe (1) ` La Sapienza di Roma II Facolta ` Medicina, Roma; (1)UOC Cardiologia, Universita (2)Clinica Montevergine, Mercogliano, Italy Introduction. Coronary Intrastent Restenosis (CIR) is a complex pathophysiological phenomenon, which involves different haemodynamic, biochemical and clinical pathways. Blood Pressure (BP) lowering demonstrated to significantly reduce incidence of coronary artery disease (CAD). What remains less clear is the potential predictive role of BP levels in the pathogenesis of CIR. Aim. To evaluate the incidence of CIR in patients with coronary single vessel disease (SVD) according to baseline clinic (peri-procedural) BP and invasive (intra-procedural) BP levels. Methods. We analysed patients of both sexes, aged 40 years or older, with established SVD, previously treated by percutaneous coronary stent intervention (PCI), and subsequently undergone coronary angiography due to symptoms or signs of at rest or stress-induced myocardial ischaemia, between July 1998 and May 2007. The diagnosis of CIR was made in the presence of angiographic evidence of a lesion determining a 50% or more occlusion of the coronary lumen. All patients received optimal pharmacologic treatment according to current CAD guidelines. Results. We included in the present analysis 337 patients with SVD (age 64.5±9.9 years, BMI 27.5±3.5, clinic BP134.5±18.4/77.0± 9.2 mmHg, invasive BP 130.2±18.1/73. 4±9.5 mmHg). During a mean observational period of 4.6±1.3 years, a total of 220 patients experienced RCI (group A,170M and 89F, age 64.5±9.9 years), while 117 patients did not shown any significant lesion (group B, 50M and 28F, age 63.0±10.4 years). These groups were homogeneous for demographic characteristics, cardiovascular and metabolic profile, severity of coronary lesion, type and number of applied stents. Baseline SBP levels were significantly higher in group A than that observed in group B, both at clinic (137±19/78±9 mmHg vs 129±15/76±9mmHg; P
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