Evidence map›Paper›PMID 28639575›Full record

SynthesisChinese medical journal2017

Account for Clinical Heterogeneity in Assessment of Catheter-based Renal Denervation among Resistant Hypertension Patients: Subgroup Meta-analysis.

Xiao-Han Chen, Sehee Kim, Xiao-Xi Zeng, Zhi-Bing Chen, Tian-Lei Cui, Zhang-Xue Hu, Yi Li, Ping Fu

Open access · goldAbstract readMeta-Analysis
In one paragraph

Synthesis in Chinese medical journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.2field-weighted citation impact, top 43% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 2 countries.

Xiao-Han ChenDepartment of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Sehee KimDepartment of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, USA.
Xiao-Xi ZengDepartment of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University; West China Biostatistics and Cost-benefit Analysis Center of Sichuan University, Chengdu, Sichuan 610041, China.
Zhi-Bing ChenDepartment of Burn and Plastic Surgery, Chengdu Second People's Hospital, Chengdu, Sichuan 610017, China.
Tian-Lei CuiDepartment of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Zhang-Xue HuDepartment of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Yi LiDepartment of Biostatistics, University of Michigan School of Public Health; Kidney Epidemiology and Cost Center, University of Michigan, Ann Arbor, Michigan 48109, USA.
Ping FuDepartment of Nephrology, Kidney Research Institute, West China Hospital, Sichuan University; West China Biostatistics and Cost-benefit Analysis Center of Sichuan University, Chengdu, Sichuan 610041, China.
Sichuan University · CNUniversity of Michigan–Ann Arbor · USChengdu Second People's Hospital · CN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCatheter-based renal denervation (RDN) is a novel treatment for resistant hypertension (RH). A recent meta-analysis reported that RDN did not significantly reduce blood pressure (BP) based on the pooled effects with mild to severe heterogeneity. The aim of the present study was to identify and reduce clinical sources of heterogeneity and reassess the safety and efficacy of RDN within the identified homogeneous subpopulations.

methodsThis was a meta-analysis of 9 randomized clinical trials (RCTs) among patients with RH up to June 2016. Sensitivity analyses and subgroup analyses were extensively conducted by baseline systolic blood pressure (SBP) level, antihypertensive medication change rates, and coronary heart disease (CHD).

resultsIn all patients with RH, no statistical differences were found in mortality, severe cardiovascular events rate, and changes in 24-h SBP and office SBP at 6 and 12 months. However, subgroup analyses showed significant differences between the RDN and control groups. In the subpopulations with baseline 24-h SBP ≥155 mmHg (1 mmHg = 0.133 kPa) and the infrequently changed medication, the use of RDN resulted in a significant reduction in 24-h SBP level at 6 months (P = 0.100 and P= 0.009, respectively). Subgrouping RCTs with a higher prevalent CHD in control showed that the control treatment was significantly better than RDN in office SBP reduction at 6 months (P < 0.001).

conclusionsIn all patients with RH, the catheter-based RDN is not more effective in lowering ambulatory or office BP than an optimized antihypertensive drug treatment at 6 and 12 months. However, among RH patients with higher baseline SBP, RDN might be more effective in reducing SBP.

Indexed as

FemaleHumansHypertensionKidneyMaleRandomized Controlled Trials as TopicRenal ArterySympathectomy

Identifiers

PMID28639575
PMCPMC5494923
OpenAlexW2657956388

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-SA
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.