Value of Clinical Pulse Pressure as a Clinical Predictor of Severity of Coronary Artery Disease in Patients Undergoing Elective Coronary Angiography

Background: Brachial blood pressure (BP) is often inaccurate, especially for diastolic and mean values, making invasive aortic pressure monitoring more reliable for assessing central BP. Aim: To assess pulse pressure (PP) as a potential clinical indicator of the severity of coronary artery disease (CAD) in individuals subjected to planned coronary angiography. Patients and Methods: This prospective observational study was executed on 300 participants, with suspected CAD undergoing planned coronary angiographic evaluation. Participants were classified into three groups based on age: Young age group: from 30 – 40 years, middle age group: from 41- 60 years and Elderly group: above 60 years. All participants were undergoing planned coronary angiography. Results: A significant variation was observed among the young, middle-aged, and older adult groups with respect to diabetes and HTN status, SBP, DBP and TLC. A highly significant difference was observed among the young, middle-aged, and elderly groups in terms of cholesterol, LDL, HDL and creatinine levels. A substantial difference was also found among the high and low–intermediate Severity Numerator TAngible Xylography scoring system (SYNTAX) score groups with respect to age, LDL, SBP, DBP, and PP. Moreover, a significant positive correlation was identified between the SYNTAX score and both LDL and PP. ROC analysis revealed that the optimal cutoff value of PP for identifying patients with a SYNTAX score >33 (high group) was >59 mmHg, yielding a sensitivity of 74.4% and a specificity of 93.8%. Conclusions: PP was a simple clinical parameter available for every doctor as a determinant of CAD.