ACTA CARDIOLOGICA, cilt.80, sa.8, ss.838-846, 2025 (SCI-Expanded)
Background: Blood pressure response during exercise testing provides valuable prognostic information. This study examined the association between blood pressure recovery ratio (BPRR) and SYNTAX score (SS) in patients with stable coronary artery disease (CAD). Methods: A total of 98 patients (mean age 57.3 +/- 7.3 years) with >= 50% lesion in >= 1 coronary artery who underwent coronary angiography after an exercise test were included. Patients were classified into low SS (<= 22) and intermediate-high SS (>22) groups. BPRR was calculated as the ratio of third-minute to peak exercise systolic blood pressure (SBP). Results: BPRR was significantly higher in the intermediate-high SS group (0.96 +/- 0.05) than in the low SS group (0.87 +/- 0.06) (p < 0.001). It showed a positive correlation with SS, E/e ' ratio, and left atrial volume, and a negative correlation with LVEF. In multivariate analysis, BPRR (OR: 1.446, p < 0.001) and LVEF (OR: 0.802, p = 0.005) were independent predictors of intermediate-high SS. Each 0.01 unit increase in BPRR increased risk by 44.6%. ROC analysis identified a BPRR cut-off of 0.928 (AUC = 0.892). Conclusions: BPRR, a simple and accessible parameter from exercise testing, is independently associated with CAD severity. It may enhance the non-invasive prediction of intermediate to high SS.