High residual platelet reactivity (66.2% vs 0%, p<0.001) and higher systolic blood pressure independently predicted the need for repeat PCI in post-CABG patients with recurrent ischemia.
Cross-Sectional (n=195)
No
Do arterial hypertension and high residual platelet reactivity predict the need for repeat PCI in post-CABG patients with recurrent ischemia?
Elevated systolic blood pressure and high residual platelet reactivity are strong independent predictors of the need for repeat PCI in post-CABG patients presenting with recurrent ischemia.
p-value: p=<0.001
Objective: To assess the prognostic impact of arterial hypertension (AH) and high residual platelet reactivity (HRPR) on the need for repeat percutaneous coronary intervention (PCI) in patients with recurrent ischemia after coronary artery bypass grafting (CABG). Design and method: This observational, single-center, cross-sectional study included 195 adults (>=18 years) with documented CABG and stable coronary artery disease presenting with recurrent ischemic symptoms 6-36 months post-surgery. Patients with atrial fibrillation, acute coronary syndrome, or on oral anticoagulants were excluded. Clinical, biochemical, and echocardiographic parameters were collected at hospitalization. HRPR was measured using VerifyNow P2Y12 assay (PRU>=208). Patients were divided according to the need for repeat PCI and analyzed using Mann-Whitney, chi-square, and logistic regression to identify predictors of re-intervention. Results: Repeat PCI was required in 136 patients (69.7%), while 59 (30.3%) did not need revascularization. Patients undergoing repeat PCI were older (71 65.8-75 vs 66 61.5-73 years, p=0.016) and had higher systolic blood pressure despite treatment with two antihypertensive agents (130 120-140 vs 120 110-130 mmHg, p=0.041). HRPR was significantly more frequent in the repeat PCI group (66.2% vs 0%, p<0.001). Coronary angiography revealed more extensive disease with greater numbers of affected vessels and grafts (median 4 3.75-5 vs 3 2-3, p<0.001). Logistic regression identified older age, higher systolic blood pressure despite dual antihypertensive therapy, HRPR, and extent of coronary lesions as independent predictors of repeat PCI. Lipid profiles, glycemic control, renal function, and inflammatory markers were comparable between groups. Conclusions: Elevated systolic blood pressure and high residual platelet reactivity strongly predict repeat PCI in post-CABG patients with recurrent ischemia. These findings emphasize the importance of strict blood pressure management and platelet function monitoring as key components of secondary prevention after CABG.
Жангелова et al. (Fri,) conducted a cross-sectional in Recurrent ischemia after coronary artery bypass grafting (CABG) (n=195). Arterial hypertension and high residual platelet reactivity vs. Normal blood pressure and normal platelet reactivity was evaluated on Need for repeat percutaneous coronary intervention (PCI) (p=<0.001). High residual platelet reactivity (66.2% vs 0%, p<0.001) and higher systolic blood pressure independently predicted the need for repeat PCI in post-CABG patients with recurrent ischemia.