Visit-to-Visit Systolic Blood Pressure Variability Predicts Long-Term Cardiovascular Events After Coronary Artery Bypass Grafting.

This prospective observational study investigated whether systolic blood pressure variability (SBPV) during the transitional care period predicts long-term outcomes after coronary artery bypass grafting (CABG). We enrolled 120 consecutive patients undergoing isolated CABG between 2020 and 2024 in a structured Transitional Care Service System. Office blood pressure was measured at scheduled visits. SBPV was quantified using the coefficient of variation (CV), and patients were stratified by median SBP-CV (8.4%) into low- and high-variability groups. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE). During a median follow-up of 46 months (corresponding to 34 months post-landmark), 19 MACCE events occurred in the landmark cohort of 116 patients (4 early events were excluded). The high-variability group experienced significantly more events than the low-variability group (26.3% vs. 6.8%, p = 0.005), with markedly reduced event-free survival (log-rank p = 0.005). After multivariable adjustment for age, diabetes mellitus, number of measurements, and mean systolic blood pressure, high SBPV remained an independent predictor of MACCE (hazard ratio 2.85, 95% confidence interval 1.12-7.24, p = 0.028). Sensitivity analyses using alternative metrics confirmed these findings, whereas mean systolic blood pressure was not predictive. In conclusion, high visit-to-visit SBPV during postoperative transitional care independently predicts long-term cardiovascular events after CABG. Monitoring blood pressure stability may enhance risk stratification in this high-risk population.