Background: Little is known about the predictive role of Cardiac Self Efficacy (CSE) in the ensuing months following a coronary event. We sought to determine whether CSE predicts adverse events in the months following discharge in patients with Coronary Artery Disease (CAD). Design: Data from a prospective study of 193 patients recently hospitalized for CAD. Methods: Data were collected via participant self-report and medical records at 3-month post-discharge (baseline; T1), 6-month post-discharge (T2) and 9-month post-discharge (T3). CSE was measured using the Cardiac Self Efficacy Scale. Multi-variate regression modeling was applied to explore the association between baseline CSE scores and cardiac-related hospital admissions and functional cardiac status at T2 and T3. Other outcomes included any hospital admissions, self-reported mental and physical health at follow up. Results: Higher CSE scores at baseline significantly predicted better cardiac functioning and self-rated mental and physical health at both T2 and T3 (with one exception); this was consistent across all five models. While baseline CSE did not predict cardiac or other hospital admission at T2, CSE was a significant predictor of both outcomes at T3; higher CSE scores resulted in reductions in likelihood of hospital admissions. After adjustment for psychosocial variables however, neither association remained. Baseline depression explained the association between baseline CSE and any cardiac admissions, as well as baseline CSE and any hospital admissions at T3 follow up. Conclusions: While CSE can predict key outcomes following a CAD event, much of the association can be explained by the presence of depression.

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Introduction and Aims: Renal denervation (RDN) may lower blood pressure (BP) in people with resistant hypertension. Here we report the combined UK experience of RDN. Methods: The UK Renal Denervation Affiliation is an independent investigator-led initiative of 16 centres, each had done >5 cases. A standardized dataset was collected retrospectively, anonymised and submitted to the coordinating centre for analysis. Results: 246 cases from 16 centres are reported. The average number of cases per centre was 15. Five different ablation technologies were used; unipolar catheters in 198 and multipolar in 48. The mean age was 56.7 years, 53% female, 87% Caucasian, and diabetes 27%. 24% percent patients had previous stroke, 15% myocardial infarction, and 26% had proteinuria. Patients were selected in accordance with the Joint UK Societies Consensus Statement 2012, by multi-disciplinary teams; 86% attended specialist hypertension clinics. On average 4.7 drugs were used before RDN; 95% were on ≥3drugs; 90% RAS blockers and diuretics, and 56% aldosterone antagonists. Pre-RDN mean office BP was 186/102 mmHg. Ambulatory blood pressure monitoring (ABPM) data were available for 179 patients (73%). Average day ABP was 170/98; night ABP was 154/86. Average follow-up was 10.7 months. Mean office BP post-RDN was 164/93, a fall of 22/9 mmHg (P<0.001). In 24% office systolic BP fell ≥ 40 mmHg. Average post-RDN day ABP was 158/92 and night ABP 145/81; fall in day ABP of 12/6 ( p<0.001). 18% had a drop in day systolic ABP ≥ 20mmHg; 9% had a fall of ≥30mmHg. A decrease in GFR of ≥25% was seen at 10 month in 5% patients. There were no significant complications. Conclusions: In 246 patients, who had RDN in 16 UK centres there was a significant improvement in BP control with 22/9 mmHg reduction in office BP and 12/6 in day ABP. This suggests that carefully selected patients with resistant hypertension, with few remaining medical options, do have a significant BP reduction following RDN.

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