AbstractOptimal blood pressure (BP) for patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) remains unclear. This study aims to identify the optimal BP by investigating the association between average office BP and future clinical events in patients undergoing PCI.

摘要接受经皮冠状动脉介入治疗（PCI）的冠状动脉疾病（CAD）患者的最佳血压（BP）仍不清楚。本研究旨在通过调查接受PCI的患者的平均办公室血压与未来临床事件之间的关联来确定最佳血压。

Consecutive patients undergoing PCI from 2012 to 2016 were included. They were divided into five groups according to the average follow-up BP after discharge. The co-primary outcomes were net adverse clinical events (NACE) and major adverse cardiac and cerebrovascular events (MACCE) up to 5 years. NACE was defined as a composite of MACCE (all-cause death, non-fatal myocardial infarction (MI), non-fatal stroke, or any revascularization) or major bleeding.

包括2012年至2016年接受PCI的连续患者。根据出院后平均随访血压将其分为五组。共同主要结局是5年内的净不良临床事件（NACE）和主要不良心脑血管事件（MACCE）。NACE被定义为MACCE（全因死亡，非致命性心肌梗塞（MI），非致命性中风或任何血运重建）或大出血的复合物。

A total of 2845 patients were included, and among them, 787 (27.7%) experienced the NACE during the follow-up period. Patients in the highest SBP group (adjusted hazard ratio [HR] 1.495, confidence interval [CI] 1.189–1.880) and lowest SBP group (adjusted HR 1.625, CI 1.214–2.176) had a significantly higher risk of 5-year NACE.

共纳入2845例患者，其中787例（27.7%）在随访期间经历了NACE。SBP最高组（校正危险比[HR]1.495，置信区间[CI]1.189-1.880）和SBP最低组（校正HR 1.625，CI 1.214-2.176）的患者发生5年NACE的风险显着更高。

Similar associations were observed between SBP and the risk of MACCE, and similar results based on DBP categories were also observed. There was a J-curve relationship between SBP and DBP with respect to 5-year NACE and MACCE. The nadir point of risk for NACE and MACCE was found at 121.4/74.8 and 120.4/73.7 mmHg.

在SBP和MACCE风险之间观察到类似的关联，并且还观察到基于DBP类别的类似结果。。NACE和MACCE的最低风险点分别为121.4/74.8和120.4/73.7 mmHg。

In patients underwent PCI, there is a significant correlation between office BP level and clinical events, indicates the importance of efforts for optimal BP control to reduce ischemic and bleeding events.Trial registration: HanYang University Medical Center (HYUMC) Registry, NCT05935397..

在接受PCI的患者中，办公室血压水平与临床事件之间存在显着相关性，表明努力实现最佳血压控制以减少缺血和出血事件的重要性。试用注册：汉阳大学医学中心（HYUMC）注册处，NCT05935397。。

IntroductionCoronary artery disease (CAD) is the main cause of death globally, and accounting for > 9 million deaths in 20171. Percutaneous coronary interventions (PCI) have increasingly been performed for revascularization in patients with CAD and have become the standard treatment in acute coronary syndrome2.

引言冠状动脉疾病（CAD）是全球死亡的主要原因，20171年死亡人数超过900万。经皮冠状动脉介入治疗（PCI）越来越多地用于CAD患者的血运重建，并已成为急性冠状动脉综合征的标准治疗方法2。

Revascularization had advanced in not only procedural aspect, but also aspect of medical treatment3,4. However, the incidence of death or cardiovascular events after revascularization is still high with a 24 to 30% event rate at 10 years5,6. To mitigate these risks of adverse events following revascularization, effective secondary prevention strategies are essential, including lifestyle management, antiplatelet therapy, and treatments for hypertension, dyslipidemia, and diabetes.There are strong epidemiological relationships between high blood pressure (BP) and CAD7.

血运重建不仅在程序方面取得了进展，而且在医疗方面也取得了进展3,4。。为了减轻血运重建后不良事件的风险，有效的二级预防策略至关重要，包括生活方式管理，抗血小板治疗以及高血压，血脂异常和糖尿病的治疗。高血压（BP）与CAD7之间存在很强的流行病学关系。

Despite hypertension being a major modifiable risk factor for CAD8, the optimal BP target for patients with CAD remains unclear. Clinical guidelines for the hypertension recommending a BP target of below 130 mmHg for the systolic blood pressure (SBP) and below 80 mmHg for the diastolic blood pressure (DBP) levels9,10,11.

尽管高血压是CAD8的主要可改变危险因素，但CAD患者的最佳血压目标仍不清楚。高血压临床指南建议收缩压（SBP）的血压目标低于130 mmHg，舒张压（DBP）水平低于80 mmHg 9,10,11。

However, the basis for these recommendations relies on studies conducted primarily on hypertensive patients, including some who also have CAD. Particularly, there is a notable lack of evidence regarding patients who have undergone PCI12. In addition, there have also been reports of a J- or U-curve association between BP and risk of adverse cardiovascular events, suggesting that excessive low BP (particularly < 110/70 or 120/70 mmHg) may be dangerous in patients with CAD13,14.

然而，这些建议的基础依赖于主要针对高血压患者进行的研究，包括一些患有CAD的患者。特别是，关于接受PCI12治疗的患者，明显缺乏证据。此外，也有报道称血压与不良心血管事件风险之间存在J或U曲线关联，这表明血压过低（特别是110/70或120/70 mmHg）可能对CAD13,14患者有危险。

Therefore, this study aimed to identify the optimal BP target by investigating the association between averag.

因此，本研究旨在通过研究平均值之间的关联来确定最佳血压目标。

Data availability

数据可用性

The datasets generated the current study are available from the corresponding author on reasonable request.

本研究产生的数据集可根据合理的要求从通讯作者处获得。

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Download referencesAuthor informationAuthor notesThese authors contributed equally: Byung Sik Kim and Jeong-Hun Shin.Authors and AffiliationsDivision of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, Guri, Republic of KoreaByung Sik Kim, Jeong-Hun Shin & Yonggu LeeDivision of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Seoul Hospital, 222 Wangsimni-ro, Sungdong-gu, Seoul, 04763, Republic of KoreaWoohyeun Kim, Hyungdon Kook, Jin-Kyu Park, Jinho Shin & Young-Hyo LimAuthorsByung Sik KimView author publicationsYou can also search for this author in.

。作者和附属机构汉阳大学医学院内科，汉阳大学古里医院，古里，韩国共和国，Jeong Hun Shin＆Yonggu Lee汉阳大学医学院内科，汉阳大学首尔医院，222 Wangsimni ro，Sungdong gu，Seoul，04763，KoreaWoohyeun Kim，Hyungdon Kook，Jin Kyu Park，Jinho Shin＆Young Hyo LimAuthorsByung Sik KimView作者出版物您也可以在中搜索这位作者。

PubMed Google ScholarJeong-Hun ShinView author publicationsYou can also search for this author in

PubMed谷歌学者Jeong Hun ShinView作者出版物您也可以在

PubMed Google ScholarWoohyeun KimView author publicationsYou can also search for this author in

PubMed Google ScholarWoohyeun KimView作者出版物您也可以在

PubMed Google ScholarHyungdon KookView author publicationsYou can also search for this author in

PubMed Google ScholarHyungdon KookView作者出版物您也可以在

PubMed Google ScholarYonggu LeeView author publicationsYou can also search for this author in

PubMed Google ScholarYonggu LeeView作者出版物您也可以在

PubMed Google ScholarJin-Kyu ParkView author publicationsYou can also search for this author in

PubMed Google ScholarJin Kyu ParkView作者出版物您也可以在

PubMed Google ScholarJinho ShinView author publicationsYou can also search for this author in

PubMed Google ScholarJinho ShinView作者出版物您也可以在

PubMed Google ScholarYoung-Hyo LimView author publicationsYou can also search for this author in

PubMed Google ScholarYoung Hyo LimView作者出版物您也可以在

PubMed Google ScholarContributionsB.S.K. contributed to the acquisition and interpretation of data, and was a major contributor in writing the manuscript. J.-H.S. contributed to the interpretation of data and also was a major contributor in writing the manuscript. W.K. and H.K.

PubMed谷歌学术贡献b。S、 K.为数据的获取和解释做出了贡献，并且是撰写手稿的主要贡献者。J、 -H.S.为数据的解释做出了贡献，也是撰写手稿的主要贡献者。W、 K.和H.K。

contributed to the acquisition and analysis of data. Y.L., J.-K.P., and J.S. provided critical revisions to the manuscript. Y.-H.L. was responsible for study design, data interpretation, and manuscript preparation. All authors read and approved the final manuscript.Corresponding authorCorrespondence to.

为数据的获取和分析做出了贡献。Y、 L.，J.-K.P。和J.S.对手稿进行了重要修订。Y、 -H.L.负责研究设计，数据解释和手稿准备。所有作者都阅读并批准了最终稿件。对应作者对应。

Young-Hyo Lim.Ethics declarations

杨孝林。道德宣言

Competing interests

相互竞争的利益

The authors declare no competing interests.

作者声明没有利益冲突。

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Reprints and permissionsAbout this articleCite this articleKim, B.S., Shin, JH., Kim, W. et al. Association of office blood pressure with ischemic and bleeding events in patients undergoing percutaneous coronary intervention.

转载和许可本文引用本文Kim，B.S.，Shin，JH。，Kim，W.等人。经皮冠状动脉介入治疗患者办公室血压与缺血和出血事件的关系。

Sci Rep 14, 20310 (2024). https://doi.org/10.1038/s41598-024-71060-8Download citationReceived: 05 March 2024Accepted: 23 August 2024Published: 02 September 2024DOI: https://doi.org/10.1038/s41598-024-71060-8Share this articleAnyone you share the following link with will be able to read this content:Get shareable linkSorry, a shareable link is not currently available for this article.Copy to clipboard.

Sci Rep 1420310（2024）。https://doi.org/10.1038/s41598-024-71060-8Download引文接收日期：2024年3月5日接受日期：2024年8月23日发布日期：2024年9月2日OI：https://doi.org/10.1038/s41598-024-71060-8Share本文与您共享以下链接的任何人都可以阅读此内容：获取可共享链接对不起，本文目前没有可共享的链接。复制到剪贴板。

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KeywordsBlood pressureCoronary artery diseaseHypertensionPercutaneous coronary intervention

关键词血压冠状动脉疾病高血压经皮冠状动脉介入治疗

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