Is elevated pulse pressure index associated with the progression of coronary artery disease in patients undergoing repeat angiography?
Elevated pulse pressure index is independently associated with and may be a better predictor of angiographic coronary artery disease progression than pulse pressure alone.
This study sought to analyze the relationship between pulse pressure (PP) index (PPI) (PP/systolic blood pressure; a less variable and objective form of PP) and coronary artery disease (CAD) progression. A registry of 193 patients was evaluated to show CAD progression by comparing current vs previous (6 months to 3 years prior) angiograms. One day after the second angiogram, we conducted ambulatory blood pressure measurements on the patients. Of the 193 patients, 65 (34%) had CAD progression. The PP and PPI were significantly higher in the progression than in the non-progression group (55 ± 12 vs. 51 ± 10 mmHg, P = .02 and .47 ± .06 vs. .42 ± .05, P = .004, respectively). Also, the PP and PPI were independently predictive of CAD progression (OR = 1.03, P = .03 and OR = 6.47, P = .01, respectively). Moreover, the correlation of PPI with low-density lipoprotein cholesterol and glycosylated hemoglobin was greater than their correlation with PP. In addition, PPI predicted CAD progression better than PP (area under the curve AUC = .649 vs. .574, P = .03). Elevated PP and PPI may be associated with the progression of CAD. PPI seems more successful in predicting CAD progression than PP.
Karadavut et al. (Fri,) studied this question.