- 期刊
Efficacy and Safety of Renal Denervation for Patients with Uncontrolled Hypertension in Taiwan: 3-Year Results From the Global SYMPLICITY Registry-Taiwan (GSR-Taiwan)
摘要
Background: It is unclear whether renal denervation (RDN) can safely result in blood pressure (BP) reductions in Asian hypertensive patients and whether such reductions would be sustainable. The study is to assess the safety and efficacy of RDN achieved by either main renal artery ablation using the Symplicity Flex^(TM) catheter or main plus branch renal artery ablations using the Symplicity Spyral^(TM) catheter in Taiwanese uncontrolled hypertensive patients enrolled in the Global SYMPLICITY Registry (GSR) with 3 years of follow-up. Methods: The GSR is a prospective, open-label, and all-comer registry to evaluate the safety and effectiveness of RDN in patients with uncontrolled hypertension worldwide. Results: Among 26 patients enrolled (mean age, 59.1 ± 13.8 years), 8 were treated with the Symplicity Flex^(TM) catheter, and 18 were treated with the Symplicity Spyral^(TM) catheter. Baseline office systolic BP was 168.2 ± 19.8 mmHg and diastolic BP was 89.0 ± 14.3 mmHg. Office BP reductions following RDN were sustained throughout the follow-up periods of up to 3 years in the Symplicity Flex^(TM) group and 2 years in the Symplicity Spyral^(TM) group. In the Symplicity Flex^(TM) group, the office systolic BP reductions were 14.9 ± 14.7 mmHg and 29.7 ± 25.9 mmHg at 3 months and 3 years, respectively (both p ＜ 0.05 from baseline). In the Symplicity Spyral^(TM) group, the office systolic BP reductions were 21.2 ± 28.7 mmHg and 42.4 ± 10.7 mmHg at 3 months and 2 years, respectively (both p ＜ 0.05 from baseline). There were no significant changes in heart rate or antihypertensive medication classes. Three protocol-defined adverse events occurred in 2 patients, including new-onset end-stage renal disease, stroke, and hospitalization for new-onset heart failure. Conclusions: Given the susceptibility of Asian populations to hypertension, RDN, as a safe antihypertensive procedure with long-lasting BP-lowering effects, could reliably serve as an alternative or complementary BP-lowering strategy for patients with uncontrolled hypertension in Taiwan and other Asian countries.
延伸閱讀
- 葉玉雄（2014）。Geographic variations of township-specific prevalence of late-stage chronic kidney disease in Taiwan: A nationwide population study〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-1906201417082200
- Tseng, P. Y., Peng, Y. S., & Yang, J. Y. (2017). Risk and Outcome of Acute Nonvariceal Upper Gastrointestinal Bleeding among Patients on Dialysis: A Nationwide Population-Based Study in Taiwan. Acta Nephrologica, 31(1), 15-21. https://doi.org/10.6221/AN.2016023
- Lai, C. P., Chang, C. C., Yang, Y., Wen, Y. K., Chiou, P. F., Chen, M. L., Yeh, K. T., & Lin, Y. M. (2010). Non-Diabetic Renal Diseases in Type 2 Diabetic Patients with Renal Involvement: Clinicopathological Study in a Single Medical Center in Taiwan. Acta Nephrologica, 24(3), 157-166. https://www.airitilibrary.com/Article/Detail?DocID=10131671-201007-201012230024-201012230024-157-166
- Wang, T. D., Lee, Y. H., Chang, S. S., Tung, Y. C., Yeh, C. F., Lin, Y. H., Pan, C. T., Hsu, C. Y., Huang, C. Y., Wu, C. K., Sung, P. H., Chiang, L. T., Wang, Y. C., Tsai, W. C., Lin, T. T., Lin, C. P., Chen, W. J., & Hwang, J. J. (2019). 2019 Consensus Statement of the Taiwan Hypertension Society and the Taiwan Society of Cardiology on Renal Denervation for the Management of Arterial Hypertension. Acta Cardiologica Sinica, 35(3), 199-230. https://doi.org/10.6515/ACS.201905_35(3).20190415A
- Wang, T. D. (2019). From Real-World Evidence to Consensus of Renal Denervation in Taiwan: A Call for the Incorporation of Ambulatory Blood Pressure Monitoring after Witnessed Intake of Medications. Acta Cardiologica Sinica, 35(6), 553-556. https://doi.org/10.6515/ACS.201911_35(6).20191103A