Blood Pressure Changes Have a More Strong Impact on Short- than Long-Term Outcomes of Major Adverse Cardiovascular Events

The purpose of our study was to explore the association of blood pressure (BP) changes on short-and long-term outcomes of major adverse cardiovascular events (MACEs) in rural China. This study was designed to learn the effects of BP changes (2004-2008) on short-term (2008-2010, within 2 years of the initial examination) and long-term (2008-2017) outcomes of MACE, including 24 285 and 27 290 participants, respectively. In this study, 423 (short-term) and 1952 (long-term) MACEs were identified. For prehypertension to hypertension, the risk of long-term stroke was increased (hazard ratio [HR] = 1.18 [1.00-1.39]). For hypertension to prehypertension, the short-term MACE risk (0.65 [0.47-0.90]), short-term stroke risk (0.45 [0.26-0.76]), and long-term stroke risk (0.83 [0.70-0.99]) all decreased. Short-term outcomes conferred a stronger impact than long-term outcomes (Fisher Z test, measured as the difference of β coefficients, all P < .05).

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Short‐term blood pressure changes have a more strong impact on stroke and its subtypes than long‐term blood pressure changes

Clinical Cardiology ◽

10.1002/clc.23242 ◽

2019 ◽

Vol 42 (10) ◽

pp. 925-933

Author(s):

Rongrong Guo ◽

Yanxia Xie ◽

Jia Zheng ◽

Yali Wang ◽

Yue Dai ◽

...

Keyword(s):

Blood Pressure ◽

Strong Impact ◽

Short Term ◽

Pressure Changes

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Shockwave Intravascular Lithotripsy for the Treatment of Severe Vascular Calcification

Angiology ◽

10.1177/0003319720932455 ◽

2020 ◽

Vol 71 (8) ◽

pp. 677-688 ◽

Cited By ~ 3

Author(s):

George Kassimis ◽

Matthaios Didagelos ◽

Giovanni Luigi De Maria ◽

Nestoras Kontogiannis ◽

Grigoris V. Karamasis ◽

...

Keyword(s):

Vascular Calcification ◽

Cardiovascular Events ◽

Percutaneous Intervention ◽

Advanced Technology ◽

Major Adverse Cardiovascular Events ◽

Atherosclerotic Cardiovascular Disease ◽

Peripheral Artery ◽

Long Term Outcomes ◽

Short And Long Term

Vascular calcification is a highly prevalent pathophenotype that is associated with aging, atherosclerotic cardiovascular disease, diabetes mellitus, and chronic kidney disease. When present, it portends a worse clinical outcome and predicts major adverse cardiovascular events. Heavily calcified coronary and peripheral artery lesions are difficult to dilate appropriately with conventional balloons during percutaneous intervention, and the use of several adjunctive strategies of plaque modification has been suggested. Intravascular lithotripsy (IVL) offers a novel option for lesion preparation of severely calcified plaques in coronary and peripheral vessels. It is unique among all technologies in its ability to modify calcium circumferentially and transmurally, thus modifying transmural conduit compliance. In this article, we summarize the currently available evidence on this technology, and we highlight its best clinical application through appropriate patient and lesion selection, with the main objective of optimizing stent delivery and implantation, and subsequent improved short- and long-term outcomes. We believe that the IVL balloon will transform the market, as it is easy to use, with predictable results. However, cost-effectiveness of such advanced technology will need to be considered.

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Effectiveness of continuous unsupervised exercise therapy after above-knee femoropopliteal bypass

Vascular ◽

10.1177/1708538120957488 ◽

2020 ◽

pp. 170853812095748

Author(s):

Taira Kobayashi ◽

Masaki Hamamoto ◽

Takanobu Okazaki ◽

Tomoaki Honma ◽

Kazutoshi Iba ◽

...

Keyword(s):

Intermittent Claudication ◽

Exercise Therapy ◽

Cardiovascular Events ◽

Major Adverse Cardiovascular Events ◽

Study Cohort ◽

Secondary Patency ◽

Femoropopliteal Bypass ◽

Long Term Outcomes ◽

Propensity Matching

Objective Exercise therapy has acceptable outcomes for patients with intermittent claudication, although few reports exist regarding the results of continuous exercise therapy after surgical reconstruction for intermittent claudication. This study aimed to analyze the long-term outcomes of unsupervised exercise therapy for patients after above-knee femoropopliteal bypass. Material and methods We retrospectively analyzed 69 patients (69 limbs, 69 grafts) who underwent above-knee femoropopliteal bypass from April 2009 to March 2018 in our hospital. At six months after above-knee femoropopliteal bypass, we evaluated the maintenance of unsupervised exercise therapy. Patients who continued unsupervised exercise therapy or discontinued unsupervised exercise therapy were assessed via 1:1 propensity matching. Long-term outcomes such as patency, survival, and major adverse cardiovascular events were compared between the groups after matching. We also analyzed the maintaining rate of unsupervised exercise therapy in a study cohort. Results Twenty-nine (42%) patients continued unsupervised exercise therapy until six months after above-knee femoropopliteal bypass. The discontinued unsupervised exercise therapy had higher proportions of female sex ( p = 0.015) and cerebrovascular disease ( p = 0.025) than did the continued unsupervised exercise therapy. The mean follow-up period was 65 ± 36 months. After propensity matching, the rates of the following factors were significantly higher in the continued unsupervised exercise therapy than in the discontinued unsupervised exercise therapy: primary patency (97% vs. 61%, p = 0.0041), secondary patency (100% vs. 69%, p = 0.0021), and freedom from major adverse cardiovascular events (61% vs. 24%, p = 0.0071) at five years. Both groups had a similar survival rate. The maintaining rate of unsupervised exercise therapy in the study cohort was 44% at six months, 41% at one year, 36% at three years, 25% at five years, and 25% at seven years. Conclusion The findings of this study suggested superior long-term outcomes, including graft patency and freedom from major adverse cardiovascular events, with unsupervised exercise therapy after open bypass than with the usual therapy. Unsupervised exercise therapy may be recommended for the patients after open bypass.

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Comparison of Long‐Term Outcomes for Responders Versus Non‐Responders Following Renal Denervation in Resistant Hypertension

Journal of the American Heart Association ◽

10.1161/jaha.121.022429 ◽

2021 ◽

Author(s):

Karl Fengler ◽

Paul Reimann ◽

Karl‐Philipp Rommel ◽

Karl‐Patrik Kresoja ◽

Stephan Blazek ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Events ◽

Blood Pressure Response ◽

Sympathetic Denervation ◽

Major Adverse Cardiovascular Events ◽

Renal Sympathetic Denervation ◽

Recent Trial ◽

Renal Sympathetic

Background Recent trial results support the efficacy of renal sympathetic denervation in lowering blood pressure (BP). While BP reduction in general is associated with a clinically meaningful reduction in cardiovascular events and mortality, such a relationship has not been described for patients undergoing renal sympathetic denervation. Methods and Results Clinical events were assessed in patients who underwent renal sympathetic denervation at our center using telephone‐ and clinical follow‐up, interviews with general practitioners, as well as review of hospital databases. Event rates were compared between BP responders (≥5 mm Hg 24‐hour ambulatory BP reduction) and non‐responders; 296 patients were included. Compared with baseline, 24‐hour systolic ambulatory BP was reduced by 8.3±12.2 mm Hg and diastolic BP by 4.8±7.0 mm Hg ( P <0.001 for both) after 3 months. One hundred eighty patients were classified as BP responders and 116 as non‐responders. During a median follow‐up time of 48 months, significantly less major adverse cardiovascular events (cardiovascular death, stroke, myocardial infarction, critical limb ischemia, renal failure) occurred in responders than in non‐responders (22 versus 23 events, hazard ratio [HR], 0.53 [95% CI, 0.28 to 0.97], P =0.041). This was consistent after adjustment for potential confounders as well as confirmed by propensity‐score matching. A proportional relationship was found between BP reduction after 3 months and frequency of major adverse cardiovascular events (HR, 0.75 [95% CI, 0.58 to 0.97] per 10 mm Hg 24‐hour systolic ambulatory BP reduction). Conclusions Based on these observational data, blood pressure response to renal sympathetic denervation is associated with improved long‐term clinical outcome.

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