TY - JOUR
T1 - Six-month outcomes of percutaneous transluminal coronary angioplasty in hypertensive patients
T2 - Results from the ROSETTA registry
AU - Tsang, Janius
AU - Sheppard, Richard
AU - Mak, Koon Hou
AU - Brown, David
AU - Huynh, Thao
AU - Schechter, David
AU - Eisenberg, Mark J.
N1 - Funding Information:
Concord Hospital, Sydney, Australia: D. Brieger; The Royal Melbourne Hospital, Parkville, Australia: J. Lefkovits, P. Singh; Jewish General Hospital, Montreal, Quebec, Canada: M. Eisenberg, P. Garzon, J. Tsang, L. Dragatakis, R. Schlesinger, E. Shalit, D. Beauvais; Montreal General Hospital, Montreal, Quebec, Canada: T. Huynh, L. Pilote, C. Boudreault; Royal Victoria Hospital, Montreal, Quebec, Canada: M. Smilovitch, R. Sheppard, A. Serpa; Hadassah Hospital, Jerusalem, Israel: D. Schechter, H. Witt; National Heart Center, Singapore: K. H. Mak; University of California at San Diego Medical Center, San Diego, Calif: D. L. Brown, E. Mahmud; St Joseph’s Hospital, Omaha, Neb: M. Del Core; University of Texas Health Center at Tyler, Tyler, Tex: U. Deligonul, S. Collins; St Luke’s Regional Medical Center, Boise, Idaho, R. Duerr; Medical College of Virginia, Richmond, Va: E. Goudreau, K. Hall, R. O’Brien; New York Veterans Administration Medical Center, New York, NY: S. Sedlis, M. Saric.
PY - 2002
Y1 - 2002
N2 - Purpose: Hypertension is an important risk factor for coronary artery disease. However, the impact of hypertension on the outcomes of patients undergoing percutaneous transluminal coronary angioplasty (PTCA) is unknown. Our purpose was to evaluate the association between hypertension and adverse outcomes and repeat cardiac procedures during the 6-month period after PTCA. Methods: We studied 791 patients who were enrolled in the Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) registry. This registry is a prospective multicenter study examining the use of functional testing after a successful PTCA. Results: We compared 411 hypertensive patients (mean age 60.1 ± 10 years, 31.1% female) with 380 normotensive patients (mean age 59.1 ± 12 years, 16.2% female). Patients with hypertension had a higher 6-month rate of composite clinical events (unstable angina, myocardial infarction, death) than did normotensive patients (16.5% vs 10.5%, P = .017). In addition, there was a trend for hypertensive patients to have higher rates of cardiac procedures (angiography, repeat PTCA, coronary artery bypass graft surgery) compared with normotensive patients (19.8% vs 14.9%, P = .074). However, functional testing after PTCA was lower among hypertensive subjects (44.4% vs 54.0%, P = .008). Among the 411 hypertensive patients, a regression analysis showed that several variables were independently associated with increased 6-month adverse event rates, including pre-PTCA Killip class III-IV (odds ratio [OR] 5.7, 95% Cl 1.7-19.0), Canadian Cardiovascular Society angina class III-IV (OR 2.1, 95% Cl 1.1-4.2), unstable angina as the reason for PTCA (OR 2.3, 95% Cl 1.2-4.3), peripheral vascular disease (OR 3.2, 95% Cl 1.5-6.4), PTCA of a bypass graft (OR 3.1, 95% Cl 1.2-7.6), and calcium antagonist usage at admission for the index PTCA (OR 1.9, 95% Cl 1.1-3.4). Conclusions: During the 6-month period after a successful PTCA, patients with hypertension have significantly higher adverse event rates than do those without hypertension. Several clinical variables may help identify which hypertensive patients are at higher risk for clinical events.
AB - Purpose: Hypertension is an important risk factor for coronary artery disease. However, the impact of hypertension on the outcomes of patients undergoing percutaneous transluminal coronary angioplasty (PTCA) is unknown. Our purpose was to evaluate the association between hypertension and adverse outcomes and repeat cardiac procedures during the 6-month period after PTCA. Methods: We studied 791 patients who were enrolled in the Routine Versus Selective Exercise Treadmill Testing After Angioplasty (ROSETTA) registry. This registry is a prospective multicenter study examining the use of functional testing after a successful PTCA. Results: We compared 411 hypertensive patients (mean age 60.1 ± 10 years, 31.1% female) with 380 normotensive patients (mean age 59.1 ± 12 years, 16.2% female). Patients with hypertension had a higher 6-month rate of composite clinical events (unstable angina, myocardial infarction, death) than did normotensive patients (16.5% vs 10.5%, P = .017). In addition, there was a trend for hypertensive patients to have higher rates of cardiac procedures (angiography, repeat PTCA, coronary artery bypass graft surgery) compared with normotensive patients (19.8% vs 14.9%, P = .074). However, functional testing after PTCA was lower among hypertensive subjects (44.4% vs 54.0%, P = .008). Among the 411 hypertensive patients, a regression analysis showed that several variables were independently associated with increased 6-month adverse event rates, including pre-PTCA Killip class III-IV (odds ratio [OR] 5.7, 95% Cl 1.7-19.0), Canadian Cardiovascular Society angina class III-IV (OR 2.1, 95% Cl 1.1-4.2), unstable angina as the reason for PTCA (OR 2.3, 95% Cl 1.2-4.3), peripheral vascular disease (OR 3.2, 95% Cl 1.5-6.4), PTCA of a bypass graft (OR 3.1, 95% Cl 1.2-7.6), and calcium antagonist usage at admission for the index PTCA (OR 1.9, 95% Cl 1.1-3.4). Conclusions: During the 6-month period after a successful PTCA, patients with hypertension have significantly higher adverse event rates than do those without hypertension. Several clinical variables may help identify which hypertensive patients are at higher risk for clinical events.
UR - http://www.scopus.com/inward/record.url?scp=0036141023&partnerID=8YFLogxK
U2 - 10.1067/mhj.2002.120290
DO - 10.1067/mhj.2002.120290
M3 - Article
C2 - 11773922
AN - SCOPUS:0036141023
VL - 143
SP - 124
EP - 129
JO - American Heart Journal
JF - American Heart Journal
SN - 0002-8703
IS - 1
ER -