Predictive Value of Central Arterial Pressure Pre-Primary Percutaneous Coronary Intervention in Patients with Acute ST-Segment Elevation Myocardial Infarction

Background: Despite advances in primary percutaneous coronary intervention (PPCI), ST-segment elevation myocardial infarction (STEMI) continues to be a significant cause of morbidity and mortality. Central arterial pressure (CAP) assessed during PPCI has emerged as a possible predictor of major adverse cardiovascular events (MACEs) after hospitalisation. Objective: To evaluate the predictive value of CAP measured at the initiation of primary PCI in STEMI patients for in-hospital MACE.
Patients and Methods: This study is a cross-sectional prospective study conducted in the Cath Lab and CCU Unit Cardiology Department of Menoufia University, Mataria Teaching Hospital, Mansoura International Hospital from June 2023 to June 2024. We studied 150 patients with STEMI underwent PPCI, they were divided into 2 groups: Group 1: Non-MACEs group includes (100 patients), and Group 2: MACEs group includes (50 patients).
Results: MACE occurred in 50 patients (33.3%) while there was no occurrence of MACE in 100 patients (66.7%). CAP parameters were strong predictors for MACE. Among them the low-pressure subgroup of CSP (<102 mmHg ) had the highest relative risk (RR = 4.37, OR =2.14 and P value < 0.001) followed by the low-pressure subgroup of CMP (< 76 mmHg) with high relative risk (RR= 4.19 , OR= 4.2 and p value < 0.001) followed by the low-pressure subgroup of CDP < 61 mmHg (RR = 3.3 , OR = 1.39 and p value = 0.004) and the low-pressure subgroup of CPP< 29 mmHg was the lowest relative risk (RR = 2.29 , OR = 2.46 and p value = 0.002). Conclusions: CAP parameters acquired during PPCI provide easily quick information on risk stratification of STEMI patients, with a good predictive potential for the incidence of MACE. Its predictive value outperforms conventional risk score (TIMI risk score and Grace score).