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Abstract: FR-PO1037

Blood Pressure and Renal Outcomes in Patients Undergoing Percutaneous Coronary Intervention

Session Information

Category: Hypertension and CVD

  • 1402 Hypertension and CVD: Clinical, Outcomes, and Trials

Authors

  • Yun, Dong hwan, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Joo, Kwon Wook, Seoul National University Hospital, Seoul, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
  • Han, Seung Seok, Seoul National University College of Medicine, Seoul, Korea (the Republic of)
Background

Patients undergoing percutaneous coronary intervention (PCI) require strict control of blood pressure (BP) because abnormal control is related with worse cardiovascular and other organ outcomes. However, discharge BP-dependent renal outcome after PCI has not been thoroughly evaluated.

Methods

A total of 8204 adult patients undergoing PCI were reviewed at Seoul National University Hospital from 2006 to 2016. Renal outcome was defined when either a doubling of serum creatinine, ≥ 50% decrease of estimated glomerular filtration rate, or end-stage renal disease developed. The risks of renal outcome and all-cause mortality were evaluated according to BPs between 8:00 AM and 10:00 AM at discharge day using multivariable Cox proportional hazard regression and additive Cox regression with penalized splines.

Results

9.5% (766 patients) of total patients reached renal outcomes during the median follow-up period of 6.5 years (maximum 13.0 years). Admission BP and discharge BP had poor correlation, and BP parameters at discharge including systolic BP (SBP), diastolic BP (DBP) and mean arterial pressure (MAP) mainly showed J-shaped relationship on renal outcome and all-cause mortality. Among BP parameters at admission and discharge, discharge SBP was the best predictor of both mortality and renal outcome. In additive Cox regression with reference BP which had minimal hazard ratios of study outcomes, there seemed to be threshold values for renal outcome (124 mmHg of SBP) and mortality (129 mmHg of SBP).

Conclusion

BP of patients undergoing PCI had J-shaped association on renal outcome and all-cause mortality. This non-linear relationship implies there could be a possible threshold of BP for renal outcome after PCI.