Long-term outcomes after renal denervation in the two defined ESC guideline-recommended patient groups: an analysis from the Global SYMPLICITY Registry DEFINE

作者：F Mahfoud, M Schlaich, R E Schmieder, L Ruilope, K Narkiewicz, G Mancia, B Williams, Vanessa DeBruin, M Boehm · 发表于：European Heart Journal · 年份：2025 · DOI：10.1093/eurheartj/ehaf784.3406 · 研究领域：Chronic Kidney Disease and Diabetes、Blood Pressure and Hypertension Studies、Dialysis and Renal Disease Management

Abstract Background/Introduction Recent ESC guidelines recommend that renal denervation (RDN) should be considered in two groups of hypertensive (HTN) patients: 1) patients with an elevated office systolic or diastolic blood pressure (BP) ≥140/90 mmHg using 3 or more antihypertensive (AH) medications and any cardiovascular disease (CVD) risk or 2) patients with an elevated BP on <3 AH medications and increased CVD risk. The Global SYMPLICITY Registry (GSR) DEFINE is the largest study of its kind evaluating the safety and efficacy of radiofrequency (RF) RDN in a real-world setting. Purpose To compare the 3-year outcomes of RF RDN in the 2 ESC guideline-defined patient groups. Methods Patients were categorized into 2 groups based on the ESC guideline recommendations: 2703 with resistant HTN on ≥3 AH drugs and with any CVD risk (group 1) and 181 with HTN on <3 AH drugs and increase CVD risk (group 2). Office BP, 24-h ambulatory BP, medications, and adverse events were compared between groups at each follow-up. Results Differences in baseline characteristics and 3 year adverse events are shown below. There was no difference in CV death between groups, but rates of all-cause death, stroke and new end stage renal disease were higher in group 2. At 3 years, both groups had similar significant reductions in office systolic BP (p<0.0001 for both): -20.6±26.8 mmHg in group 1 and -18.8±29.1 mmHg in group 2. Changes in 24h SBP were -9.6±20.9 and -5.6±18.1 mmHg in gro...