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. 2019 May 27;19(1):124.
doi: 10.1186/s12872-019-1107-2.

Optimal blood pressure control for patients after thoracic endovascular aortic repair of type B aortic dissection

Nan Lu  1 , Xiaojing Ma  2 , Tan Xu  1 , Zhuoqiao He  1 , Bayi Xu  1 , Qingfeng Xiong  2 , Xuerui Tan  3
Affiliations

Optimal blood pressure control for patients after thoracic endovascular aortic repair of type B aortic dissection

Nan Lu et al. BMC Cardiovasc Disord. .

Abstract

Background: Guidelines recommend tight systolic blood pressure (SBP) control for favorable outcomes of type B aortic dissection (BAD) but are still limited by the optimal cut-off value of SBP. The purpose of this study was to evaluate the optimal cut-off value of SBP in BAD patients after thoracic endovascular aortic repair (TEVAR).

Methods: From January 2011 to April 2017, 269 consecutive patients with BAD after TEVAR were included in the study. All patients were followed up according to a strict follow-up protocol. Cox regression analysis was used to examine the association between SBP at discharge and 90-day aortic related adverse events (ARAE).

Results: All 269 patients completed 90 days of follow-up, and the unadjusted ARAE-free rates at 90-day was 95.1 ± 1.3%. The cut-off value of SBP at discharge identified by receiver operator curve was 130 mmHg for 90-day ARAE. In multivariable models, binary SBP at discharge was significant associated with 90-day ARAE (HR 3.780; 95% CI 1.236-11.556; p = 0.020). Hybrid operation (OR 2.046; 95%CI 1.015-4.122; p = 0.045) and insertion of ≥2 stents (OR 2.950; 95%CI 1.172-7.426; p = 0.022) were demonstrated to be independently associated with poor SBP control (SBP > 130 mmHg) using Logistic analysis.

Conclusions: The optimal cut-off value of SBP at discharge was 130 mmHg which can be used to predict short-term ARAE. Blood pressure in patients with hybrid operation and ≥ 2 stents should be given more focus.

Keywords: Aortic related adverse events; Optimal blood pressure; Thoracic endovascular aortic repair; Type B aortic dissection.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Free of ARAE of patients divided by systolic blood pressure at discharge. Kaplan-Meier calculation of freedom from development of ARAE in BAD patients after TEVAR by grouping with systolic blood pressure at discharge. (ARAE: aortic-related adverse events; BAD: type B aortic dissection; TEVAR: thoracic endovascular aortic repair)
See this image and copyright information in PMC

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