Door to Balloon Times in STEMI Patients: A Five-Year Trend at the Prince Charles Hospital

Abstract

artery in patients with resistant hypertension. The effect on central BP is less clear. Aim: To compare the effects of RDN on central and peripheral BP. Method: Thirty patients referred to Princess Alexandra Hospital RDN service were screened. Inclusion criteria: (1) peripheral BP >160/90 or (2) 24 ambulatory BP mean >150/90 or (3) home BP diary >150/90 on ≥3 drugs or (4) (i) ≥4 drugs to maintain normotension and (ii) evidence of end organ damage or (5) in the consensus opinion of the RDN Team, unique patient factors are such that the patient could potentially benefit from RDN therapy (e.g. severe intolerance to multiple medications). Patients were required to undergo a reasonable search for secondary causes and a period of appropriate medical therapy up titration. Central BP was measured non invasively using a SyphgmoCor Device. Results: Thirteen procedures on 12 patients. Eleven males. Mean age 54. Median 6 antihypertensives. Results at six months: peripheral systolic BP reduction from 171 ± 29 mmHg to 160 ± 31 mmHg (mean −11 mmHg, 95% CI (−36.4 to 14.4)). Peripheral diastolic BP reduction from 101 ± 21 mmHg to 96 ± 21 mmHg (mean −5 mmHg, 95% CI (−27.4 to 17.4)). Central systolic BP reduction from 149 ± 30 mmHg to 143 ± 36 (mean −6 mmHg, 95% CI (−34.3 to 21.8)). Conclusion: In our experience RDN shows a trend to decreasing peripheral brachial BP by a larger amount than central BP. This may have implications for long term morbidity and mortality benefits. Larger patient numbers will be required to achieve adequate statistical power and the trial is ongoing.