Association Between Office Blood Pressure and Long-Term Clinical Events in Patients With Coronary Artery Disease After Percutaneous Coronary Intervention

Objective: The optimal blood pressure (BP) target for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains unclear. This study aimed to identify the optimal BP target by investigating the association between average office BP and future clinical events after PCI in patients with CAD. Design and method: Consecutive patients undergoing PCI from 2012 to 2016 were included. They were divided into five groups according to the average follow-up BP after discharge. The co-primary outcome was major adverse cardiac and cerebrovascular event (MACCE: all-cause death, non-fatal myocardial infarction, non-fatal stroke, or any revascularization) and net adverse clinical events (NACE: MACCE, or major bleeding) up to 5 years. Results: A total of 2,845 patients were included in the analyses, and among them, 787 (27.7%) experienced the NACE during the follow-up period. Patients in the highest SBP group (adjusted hazard ratio [HR] 1.495, confidence interval [CI] 1.189–1.880) and lowest SBP group (adjusted HR 1.625, CI 1.214–2.176) had a significantly higher risk of 5-year NACE. Similar associations were observed between SBP and the risk of MACCE, and similar results based on DBP categories were also observed. There was a J-curve relationship observed between SBP and DBP with respect to 5-year NACE and MACCE. The nadir point of risk for NACE and MACCE was found at 121.4/74.8 and 120.4/73.7 mmHg. Conclusions: In patients underwent PCI, there is a significant correlation between office BP level and clinical events, which indicates the importance of efforts for optimal BP control to reduce ischemic and bleeding events.