Author + information
- Maday Gonzalez,
- Pedro Villablanca Spinetto,
- Arthur Omondi,
- Mohammed Makkiya,
- Peter Vlismas and
- Jose Wiley
Background: Percutaneous renal denervation (RDN) was heralded as a novel approach to treat resistant hypertension (RH), however evidence supporting its efficacy is conflicting. We therefore conducted an updated meta-analysis of randomized controlled trials (RCT's) evaluating the effect of RDN on blood pressure and major adverse cardiovascular events (MACE).
Methods: Relevant RCT's assessing the effect of RDN on office systolic and diastolic blood pressure (SBP and DBP) and MACE (death, stroke and myocardial infarction) were identified by search of PubMed Central, EMBASE, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov Website, and the Google Scholar database through September 2016. Cochrane Collaboration Risk of Bias Tool was used for study quality assessment. Analysis was done using a random-effects model with inverse variance weighting.
Results: Six RCT's (n=951 patients) met our criteria and were included in the analysis. In subjects undergoing RDN the pooled reductions in mean office SBP and DBP were -10.75 mmHg (95% CI -20.46 to -1.04; p=0.03), and -4.08 mmHg (95% CI -7.16 to -1.00; p=0.01), respectively, after 6 months of follow up as compared to controls. Reductions in mean 24-hour SBP and DBP were -3.41 mmHg (95%CI -5.64 to -1.18; p< 0.01) and -1.8 mmHg (95%CI -3.27 to -0.32; p=0.02) respectively, versus controls. There was no difference in the effect of RDN on MACE (RR 0.64, 95%CI 0.37 to 1.13; p=0.13). Exclusion of a single study from the analysis did not change the findings. No evidence of publication bias was observed.
Conclusions: Based on our meta-analysis of current RCT's, RDN is effective in reducing mean office and 24-hour blood pressure in patients with RH, without an increase in MACE. Longer-term follow-up and larger trials are needed to confirm the efficacy and safety of RDN.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Beans, Beans, Good for Your Heart
Abstract Category: 39. Vascular Medicine: Endovascular Therapy
Presentation Number: 1255-359
- 2017 American College of Cardiology Foundation