Key result
Hypertension with high arterial stiffness linked to ~56% greater NACE risk in PCI patients.
Why the study?
The clinical implications of arterial stiffness in relation to hypertension remained unclear in patients undergoing PCI, prompting evaluation of whether it provides additional prognostic information regarding hypertension-related risks.
Does the combination of arterial stiffness index (baPWV) and hypertensive status improve prognostic risk stratification for ischemic and bleeding events in patients undergoing PCI?
Cohort (n=3,930)
Yes
Does the combination of arterial stiffness index (baPWV) and hypertensive status improve prognostic risk stratification for ischemic and bleeding events in patients undergoing PCI?
The combined use of brachial-ankle pulse wave velocity and hypertension phenotype enhances post-PCI risk stratification, identifying a high-risk subgroup with significantly increased rates of ischemic and bleeding events.
Intensified monitoring may be warranted in hypertensives with high arterial stiffness post-PCI; extends risk stratification for ischemic and bleeding events.
Background:The clinical implications of arterial stiffness in relation to hypertension remain unclear in patients undergoing percutaneous coronary intervention (PCI).This study aimed to determine whether the arterial stiffness index provides additional prognostic information regarding hypertension-related risks in this population.Methods: Arterial stiffness was measured using brachial-ankle pulse wave velocity (baPWV) in 3,930 PCI patients before discharge.The primary outcome was net adverse clinical events (NACE), a composite of major adverse cardiac and cerebrovascular events (MACCE: all-cause death, myocardial infarction, stroke) and major bleeding over 4 years.The patients were categorized into four groups based on hypertensive status and baPWV phenotype (< 1891 vs. 1,891 cm/s).Results: Compared to hypertensive status, the baPWV phenotype showed a stronger association with clinical outcomes.Hypertensive status and baPWV phenotype showed an additive effect on risk stratification.The highest incidence rates of clinical events were observed in the hypertensives with high baPWV, followed by the normotensives with high baPWV, hypertensives with low baPWV, and normotensives with low baPWV groups.Specifically, the 4-year incidence of NACE was 14.8%, 12.4%, 7.1%, and 6.0%, respectively, and the corresponding incidences of MACCE were 12.7%, 9.5%, 6.2%, and 5.2%, respectively.The hypertensives with high baPWV group exhibited significantly higher risks for NACE (adjusted hazard ratio [aHR], 1.556; 95% confidence interval [CI], 1.132-2.138;
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Kim et al. (2026) conducted a cohort in Coronary artery disease undergoing percutaneous coronary intervention (n=3,930). Hypertension with high baPWV (≥ 1,891 cm/s) vs. Normotension with low baPWV (< 1,891 cm/s) was evaluated on Net adverse clinical events (NACE) (HR 1.556, 95% CI 1.132-2.138, p=0.006). Hypertension with high arterial stiffness increased the 4-year risk of net adverse clinical events by 56% (HR 1.556) in PCI patients compared to normotensives with low arterial stiffness.
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