HERCULES Trial Demonstrates Significant Reduction in Systolic Blood Pressure While Revealing Marker in Hypertensive Patients Does Not Predict Outcomes of Renal Artery Stenting
BALTIMORE, May 5, 2011 /PRNewswire/ -- A substance secreted by the heart that is associated with congestive heart failure and renal failure is not predictive of reduction in systolic blood pressure in patients treated with renal artery stenting, according to results from the HERCULES trial presented as a Late-Breaking Clinical Trial at the Society for Cardiovascular Angiography and Interventions (SCAI) 2011 Scientific Sessions in Baltimore.
The HERCULES trial is a prospective, multicenter trial of renal stenting in patients who have blockages to their renal arteries, which can worsen hypertension and threaten kidney function. The study reviewed outcomes for 202 patients (241 lesions) with uncontrolled hypertension who were treated with a renal artery stent between August 2007 and October 2009. The primary endpoint was 9-month restenosis rate and the secondary endpoints included changes in blood pressure, anti-hypertensive medications, renal function and the predictive value of brain natriuretic peptide (BNP).
The primary endpoint of the study was met, with a 9-month restenosis rate of 10.5 percent (p<0.0001), which was significantly lower than the performance goal of 28.6 percent. Results for the secondary endpoints showed systolic blood pressure (SBP) decreased significantly after stenting with no change in medication requirements, but mean BNP levels remained elevated after one month. The study found no evidence of a correlation between elevated pre-treatment BNP levels and SBP reduction at follow-up. Researchers measured BNP prior to treatment, at 24 hours and 30 days.
"The clinical results are promising, as we found very low restenosis rates and a significant drop in blood pressure following renal artery stenting," said Michael R. Jaff, D.O., medical director of the Vascular Center at Massachusetts General Hospital in Boston. "One goal of the study was to identify a means to predict which patients will have the best outco