Aortic pulse pressure and extent of coronary artery disease in percutaneous transluminal coronary angioplasty candidates.
BACKGROUND
Pulse pressure and aortic stiffness are both predictors of coronary artery disease. Whether these parameters are directly related to coronary structural alterations has never been studied.


METHODS
From September 1999 to September 2000, the following data were collected from 99 eligible patients: invasive intra-aortic systolic and diastolic blood pressures (BP), extent of coronary artery disease, cardiovascular risk factors, and the incidence of angiographically documented restenosis after coronary angioplasty.


RESULTS
In the study population, independent determinants of aortic pulse pressure were age, gender, aortic mean BP, heart rate, and extent of coronary artery disease (r2 = 0.57, P < .0001). In univariate analysis, invasive aortic, but not noninvasive brachial, mean pressure (P = .017) and pulse pressure (P = .027) were significantly associated to the extent of coronary artery disease. In a multiple regression analysis, only male gender (P = .013) and the level of aortic pulse pressure (P = .023) were independently associated with the extent of coronary heart disease. Restenosis was angiographically documented in 11 patients (11%). There was a borderline significant association of restenosis to aortic mean BP (P = .05) and to a past history of multiple previous angioplasties (P = .03).


CONCLUSIONS
In this study, aortic pulse pressure was a significant risk factor for the extent of coronary artery disease. There was only a borderline significant association of restenosis to the steady, but not pulsatile, component of aortic BP in the stent era.
Philippe
François
F
Département de cardiologie, Institut Mutualiste Montsouris, Paris France.
Chemaly
Elie
E
Blacher
Jacques
J
Mourad
Jean-Jacques
JJ
Dibie
Alain
A
Larrazet
Fabrice
F
Laborde
François
F
Safar
Michel E
ME
D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D001011:Aorta / Q000503:physiopathology; D001794:Blood Pressure; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000209:etiology / Q000503:physiopathology*; D023903:Coronary Restenosis / Q000209:etiology; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D014655:Vascular Resistance