Objective: We aimed to investigate the relation between Blood Pressure Variability (BPV) and coronary artery remodeling in patients with coronary artery disease coronary by intravascular ultrasound (IVUS).
Materials and methods: Coronary artery remodeling derived from IVUS was calculated in 109 patients with stable coronary artery disease (CAD), who were scheduled for percutaneous coronary intervention. The remodeling index was defined as the ratio of the external elastic membrane (EEM) area at the lesion site to the EEM area at the proximal reference site. Patients were stratified into 2 groups: group I included patients with positive remodeling (RI ≥ 1.05) (n=59), and group II included those with intermediate remodeling/negative remodeling (RI<1.05) (n=50). 24 hours ambulatory blood pressure parameters were obtained. In our study we calculate the weighted systolic blood pressure standard deviation-day and night (W-SDdn) as the BPV index.
Results: Weighted-SDdn and morning blood pressure surge (MBPS) were significantly higher in group I patients (PR) compared with group II (IR/NR) p<0.001. Remolding index was significantly correlated with TG/HDL-C and hs- CRP (p<0.01 and<0.05 respectively. TG/HDL-C was significantly correlated with BPV index (p<0.003). Multivariate analysis showed that weight-SDdn and MBPS were the independent predicting positive remodeling in our cohort. ROC curve analysis showed that, the cut-off values of ≥ 13 mmHg and ≥ 45 mmHg for weighted SDdn and MBPS were found to be the best cut-off values for predicting positive remodeling in patients with stable CAD
Conclusion: We suggest that blood pressure variability index (W-SDdn) and MBPS are associated with positive coronary artery remodeling index independent of coronary artery disease risk factors in patients with stable CAD.