Nondipping pulse rate was independently associated with major adverse cardiac events (MACE) in acute coronary syndrome patients post-PCI (HR 2.69, 95% CI 1.06–6.86).
Does a nondipping pulse rate or blood pressure pattern increase the risk of MACE in ACS patients who underwent PCI?
In patients with ACS undergoing PCI, a nondipping pulse rate on 24-hour ambulatory monitoring is independently associated with an increased risk of major adverse cardiac events.
Absolute Event Rate: 0% vs 0%
Objectives To evaluate 24-h ambulatory systolic blood pressure (BP), diastolic BP, and pulse rate patterns in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), and their association with major adverse cardiac events (MACE). Methods We conducted a prospective cohort study in ACS patients in who ambulatory BP monitoring was recorded during 2 weeks post-PCI. Clinical and laboratory factors correlated with dipping BP and pulse rate were analyzed by multivariable logistic regression analysis. A Cox proportional hazard model was applied to find the associated factor(s) with their MACE. Results We included 141 patients with ST-elevation myocardial infarction (STEMI) ( n = 47) and non-STEMI ( n = 94). The average age was 61.7 ± 11.1 years. Most of them are men (63.8%), had non-STEMI (66.7%), and triple vessel disease (51.1%). Upon assessment of nocturnal dipping BP, 22% were dippers, while the others were nondippers and reverse dippers (39.7 and 38.3%, respectively). Nocturnal hypertension, neutrophil-to-lymphocyte, and mean platelet volume were significantly associated with nondippers adjusted odds ratio: 5.71, 95% confidence interval (CI): 2.51–12.99; 1.29, 95% CI: 1.01–1.63; 1.84, 95% CI: 1.16–2.93, respectively. Nondipping pulse rate was found in 66.0% with a mean pulse rate of 75.4 ± 10.9 beats per minute (bpm) (awake) and 70.0 ± 11.2 bpm (sleep). Nondipping pulse rate was only found as an independent factor associated with MACE (hazard ratio: 2.69, 95% CI: 1.06–6.86, P = 0.04). Conclusion This study demonstrated a significant association of MACE with nondipping pulse rate in patients with ACS who underwent PCI.
Leowattana et al. (Thu,) reported a other. Nondipping pulse rate was independently associated with major adverse cardiac events (MACE) in acute coronary syndrome patients post-PCI (HR 2.69, 95% CI 1.06–6.86).