Ambulatory blood pressure and pulse rate patterns in acute coronary syndrome patients underwent percutaneous coronary intervention

OBJECTIVES: To evaluate 24-h ambulatory systolic blood pressure (BP), diastolic BP, and pulse rate patterns in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI), and their association with major adverse cardiac events (MACE). METHODS: We conducted a prospective cohort study in ACS patients in who ambulatory BP monitoring was recorded during 2 weeks post-PCI. Clinical and laboratory factors correlated with dipping BP and pulse rate were analyzed by multivariable logistic regression analysis. A Cox proportional hazard model was applied to find the associated factor(s) with their MACE. RESULTS: We included 141 patients with ST-elevation myocardial infarction (STEMI) ( n = 47) and non-STEMI ( n = 94). The average age was 61.7 ± 11.1 years. Most of them are men (63.8%), had non-STEMI (66.7%), and triple vessel disease (51.1%). Upon assessment of nocturnal dipping BP, 22% were dippers, while the others were nondippers and reverse dippers (39.7 and 38.3%, respectively). Nocturnal hypertension, neutrophil-to-lymphocyte, and mean platelet volume were significantly associated with nondippers [adjusted odds ratio: 5.71, 95% confidence interval (CI): 2.51-12.99; 1.29, 95% CI: 1.01-1.63; 1.84, 95% CI: 1.16-2.93, respectively]. Nondipping pulse rate was found in 66.0% with a mean pulse rate of 75.4 ± 10.9 beats per minute (bpm) (awake) and 70.0 ± 11.2 bpm (sleep). Nondipping pulse rate was only found as an independent factor associated with MACE (hazard ratio: 2.69, 95% CI: 1.06-6.86, P = 0.04). CONCLUSION: This study demonstrated a significant association of MACE with nondipping pulse rate in patients with ACS who underwent PCI.