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亚洲人群肾去神经术后的长期结果:来自韩国的全球 SYMPLICITY 注册研究(GSR Korea)的结果。

Long-term outcomes after renal denervation in an Asian population: results from the Global SYMPLICITY Registry in South Korea (GSR Korea).

机构信息

Department of Internal Medicine, Cardiology Division, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

Department of Internal Medicine, Cardiovascular Center, Seoul National University College of Medicine, Seoul, Korea.

出版信息

Hypertens Res. 2021 Sep;44(9):1099-1104. doi: 10.1038/s41440-021-00683-5. Epub 2021 Jun 18.

Abstract

The objective of this work was to investigate the long-term safety and efficacy of renal denervation in Korean patients from the Global SYMPLICITY Registry (GSR). GSR Korea is a substudy of GSR with additional inclusion and exclusion criteria compared to GSR, including inclusion criteria of office systolic blood pressure ≥160 mmHg, or ≥150 mmHg for type 2 diabetes patients, while receiving 3 or more antihypertensive medications without changes for 2 weeks prior to enrollment. Renal denervation was performed using a Symplicity Flex catheter for ablation in the main renal arteries. Changes in office systolic blood pressure and adverse events were collected for up to 36 months of follow-up for 102 patients in GSR Korea. In addition, adverse events and reductions in office systolic blood pressure were analyzed for patients with and without type II diabetes mellitus. Renal denervation led to mean (± standard deviation) reductions in office systolic blood pressure at 12, 24, and 36 months in GSR Korea (-26.7 ± 18.5, -30.1 ± 21.6 mmHg, and -32.5 ± 18.8, respectively). The proportion of patients with a ≥10 mmHg office systolic blood pressure reduction from baseline was 86.3% at 12 months, 86.5% at 24 months, and 89.7% at 36 months. Adverse events at 3 years were rare. In addition, reductions in office systolic blood pressure were similar for patients with vs. without diabetes mellitus (p > 0.05 at all timepoints). Office systolic blood pressure was safely reduced at up to 36 months post-renal denervation in GSR Korea, and adverse events were rare. In addition, patients with and without diabetes had similar office systolic blood pressure reductions.

摘要

本研究旨在探讨全球 SYMPLICITY 注册研究(GSR)中韩国患者接受肾脏去神经支配术的长期安全性和有效性。GSR 韩国是 GSR 的一个子研究,与 GSR 相比,其纳入和排除标准有所不同,包括纳入标准为诊室收缩压≥160mmHg,或 2 型糖尿病患者≥150mmHg,且在入组前 2 周内接受≥3 种降压药物治疗且未调整剂量。使用 Symplicity Flex 消融导管对主肾动脉进行消融以实现肾脏去神经支配。对 102 例 GSR 韩国患者进行了长达 36 个月的随访,收集诊室收缩压变化和不良事件数据。此外,还分析了伴或不伴 2 型糖尿病患者的不良事件和诊室收缩压降低情况。GSR 韩国患者在 12、24 和 36 个月时诊室收缩压的平均(±标准差)降幅分别为-26.7±18.5mmHg、-30.1±21.6mmHg 和-32.5±18.8mmHg。与基线相比,诊室收缩压降幅≥10mmHg 的患者比例在 12 个月时为 86.3%,24 个月时为 86.5%,36 个月时为 89.7%。3 年时不良事件罕见。此外,伴或不伴糖尿病患者的诊室收缩压降低情况相似(所有时间点 p均>0.05)。GSR 韩国患者在肾脏去神经支配术后长达 36 个月时诊室收缩压可安全降低,且不良事件罕见。此外,伴或不伴糖尿病患者的诊室收缩压降低情况相似。

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