Abstract:
INTRODUCTION:Chronic kidney disease (CKD) constitutes a predictor of adverse events for surgical aortic valve replacement. In patients undergoing TAVI no study was performed to evaluate outcomes according to renal clearance, which represents the most accurate instrument to assess kidney function. METHODS:From January 2007 to December 2011 all TAVI patients of our institutions were prospectively divided into 3 cohorts. Preserved renal function those with clearance more or equal to 60 ml/min/1.73 m2, moderate CKD those between 30 and 60, and severe CKD those between 15 and 30. Patients with a clearance less than 15 or in dialysis were excluded. All outcomes were adjudicated according to VARC criterion. RESULTS:72 patients with preserved renal function, 219 with moderate and 73 with severe CKD were included; those in the latter group were older and with lower ejection fraction. At 30 days, severe CKD was associated with a trend toward a higher risk of major events than preserved and moderate CKD: cardiovascular death (2.8% vs 6.7% vs 9%; p=0.256) life threatening bleedings (10% vs 10% vs 16%; p=0.384), major stroke (1.4% vs 2.3% vs 4.1%; p=0.763). At a medium follow-up of 540 ± 250 days, cardiovascular death incidence was higher in patients with severe CKD (7% vs 8 vs 19%; p<0.0001), however this difference was not consistently significant after multivariable adjustment (p=0.300). Overall, 2% of patients developed kidney failure, whereas 47.1% of patients with severe CKD improved to moderate renal impairment. CONCLUSIONS:Patients with severe chronic renal disease presented higher risk of adverse events, mainly driven by increased hazard of bleedings. TAVI procedures could offer kidney functional improvement in an important subset of patients.
journal_name
Int J Cardioljournal_title
International journal of cardiologyauthors
D'Ascenzo F,Moretti C,Salizzoni S,Bollati M,D'Amico M,Ballocca F,Giordana F,Barbanti M,Ussia GP,Brambilla N,Bedogni F,Biondi Zoccai G,Tamburino C,Gaita F,Sheiban Idoi
10.1016/j.ijcard.2012.04.161subject
Has Abstractpub_date
2013-08-20 00:00:00pages
1514-8issue
4eissn
0167-5273issn
1874-1754pii
S0167-5273(12)00718-8journal_volume
167pub_type
杂志文章,多中心研究abstract::With the advent of transesophageal echocardiography (TEE), thrombi of the aorta are becoming increasingly recognized as possible sources of systemic emboli. This report describes a 58-year-old woman with multiple unexplained peripheral emboli. A giant thrombus of the descending aorta has been identified as the source ...
journal_title:International journal of cardiology
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journal_title:International journal of cardiology
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journal_title:International journal of cardiology
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:International journal of cardiology
pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,meta分析
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更新日期:2013-09-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,随机对照试验
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更新日期:2017-08-15 00:00:00