Background: Although brachial–ankle pulse wave velocity (baPWV) has been used to predict cardiovascular events, studies comparing it with brachial pulse pressure (brPP) for predictive value have been lacking. We investigated how brPP and baPWV differ in their ability to predict future cardiovascular events. Methods: We retrospectively reviewed the clinical data of 11,703 consecutive patients where brPP and baPWV measurements had been made. The primary endpoint was differences in the incidence of major adverse cardiovascular and cerebrovascular events (MACCE). Results: Participants had a median age of 61 years, and men accounted for 57.7% of the cohort. During a median follow-up duration of 3.64 years, 347 (3.0%) MACCE occurred. Using established reference values of baPWV > 1800 cm/s and brPP > 60 mmHg, we, respectively, stratified patients by these values. Kaplan–Meier survival curve analysis revealed that both high baPWV and brPP groups displayed elevated MACCE incidence, all-cause mortality, and cardiovascular mortality. After controlling for potential confounders, multivariate Cox regression analysis showed that individuals with elevated baPWV had higher rates of MACCE, overall mortality, and cardiovascular death, whereas brPP was not significantly associated with these outcomes. Subgroup analysis showed a consistent difference in MACCE incidence across all subgroups when stratified by baPWV; however, the significance disappeared in several subgroups when stratified by brPP. Conclusions: baPWV exhibited a stronger association with MACCE incidence than brPP. Thus, baPWV may be a more effective factor than brPP for cardiovascular risk stratification.

Jeon BK, et al. J Cardiovasc Interv. 2023 Aug;2:e28. https://doi.org/10.54912/jci.2023.0015

Background: Adequate distal perfusion assessment is crucial for managing chronic limb-threatening ischemia (CLTI). Skin perfusion pressure (SPP) and transcutaneous oxygen pressure (TcPO ₂ ) are commonly used to evaluate perfusion and predict wound healing. The main objective of this study was to compare the effectiveness of SPP and TcPO ₂ in predicting early wound healing following endovascular therapy (EVT) for CLTI. Methods: We retrospectively reviewed 99 limbs from 87 patients with Rutherford category 5 or 6 CLTI enrolled in the K-VIS ELLA registry ( ClinicalTrials.gov Identifier: NCT02748226 ). SPP and TcPO ₂ were measured before and within 48 hours after EVT. Clinical outcomes included early wound healing (defined as complete epithelialization without major amputation within 3 months), major amputation, repeat revascularization, major adverse limb events (MALE), and all-cause death. Results: A high post-EVT SPP (⩾ 48 mmHg) significantly predicted early wound healing and was associated with a higher proportion of wound healing and a lower risk of repeat revascularization at 6 months. TcPO ₂ did not significantly predict early wound healing; however, a high post-EVT TcPO ₂ (⩾ 27 mmHg) correlated with lower proportions of repeat revascularization and MALE at 6 months. Neither SPP nor TcPO ₂ was associated with mortality or major amputation. Conclusion: High SPP within 48 hours post-EVT was a significant predictor of early wound healing in CLTI. Although TcPO ₂ was not predictive of early wound healing, it was linked to other favorable limb outcomes. Further studies are required to validate our findings and define the complementary roles of SPP and TcPO ₂ in managing CLTI.