Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation
Copyright © 2017 by the American Society of Nephrology..
BACKGROUND AND OBJECTIVES: Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data from all hospitalized patients who underwent transcatheter aortic valve implantation procedures between January 1, 2010 and December 31, 2013 in Germany were evaluated regarding influence of CKD, even in the earlier stages, on morbidity, in-hospital outcomes, and costs.
RESULTS: A total of 28,716 patients were treated with transcatheter aortic valve implantation. A total of 11,189 (39.0%) suffered from CKD. Patients with CKD were predominantly women; had higher rates of comorbidities, such as coronary artery disease, heart failure at New York Heart Association 3/4, peripheral artery disease, and diabetes; and had a 1.3-fold higher estimated logistic European System for Cardiac Operative Risk Evaluation value. In-hospital mortality was independently associated with CKD stage ≥3 (up to odds ratio, 1.71; 95% confidence interval, 1.35 to 2.17; P<0.05), bleeding was independently associated with CKD stage ≥4 (up to odds ratio, 1.82; 95% confidence interval, 1.47 to 2.24; P<0.001), and AKI was independently associated with CKD stages 3 (odds ratio, 1.83; 95% confidence interval, 1.62 to 2.06) and 4 (odds ratio, 2.33; 95% confidence interval, 1.92 to 2.83 both P<0.001). The stroke risk, in contrast, was lower for patients with CKD stages 4 (odds ratio, 0.23; 95% confidence interval, 0.16 to 0.33) and 5 (odds ratio, 0.24; 95% confidence interval, 0.15 to 0.39; both P<0.001). Lengths of hospital stay were, on average, 1.2-fold longer, whereas reimbursements were, on average, only 1.03-fold higher in patients who suffered from CKD.
CONCLUSIONS: This analysis illustrates for the first time on a nationwide basis the association of CKD with adverse outcomes in patients who underwent transcatheter aortic valve implantation. Thus, classification of CKD stages before transcatheter aortic valve implantation is important for appropriate risk stratification.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:12 |
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| Enthalten in: |
Clinical journal of the American Society of Nephrology : CJASN - 12(2017), 5 vom: 08. Mai, Seite 718-726 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Lüders, Florian [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 05.03.2018 Date Revised 13.08.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.2215/CJN.10471016 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM269797165 |
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| 245 | 1 | 0 | |a Association of CKD with Outcomes Among Patients Undergoing Transcatheter Aortic Valve Implantation |
| 264 | 1 | |c 2017 | |
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| 500 | |a Date Completed 05.03.2018 | ||
| 500 | |a Date Revised 13.08.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2017 by the American Society of Nephrology. | ||
| 520 | |a BACKGROUND AND OBJECTIVES: Despitethe multiple depicted associations of CKD with reduced cardiovascular and overall prognoses, the association of CKD with outcome of patients undergoing transcatheter aortic valve implantation has still not been well described | ||
| 520 | |a DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Data from all hospitalized patients who underwent transcatheter aortic valve implantation procedures between January 1, 2010 and December 31, 2013 in Germany were evaluated regarding influence of CKD, even in the earlier stages, on morbidity, in-hospital outcomes, and costs | ||
| 520 | |a RESULTS: A total of 28,716 patients were treated with transcatheter aortic valve implantation. A total of 11,189 (39.0%) suffered from CKD. Patients with CKD were predominantly women; had higher rates of comorbidities, such as coronary artery disease, heart failure at New York Heart Association 3/4, peripheral artery disease, and diabetes; and had a 1.3-fold higher estimated logistic European System for Cardiac Operative Risk Evaluation value. In-hospital mortality was independently associated with CKD stage ≥3 (up to odds ratio, 1.71; 95% confidence interval, 1.35 to 2.17; P<0.05), bleeding was independently associated with CKD stage ≥4 (up to odds ratio, 1.82; 95% confidence interval, 1.47 to 2.24; P<0.001), and AKI was independently associated with CKD stages 3 (odds ratio, 1.83; 95% confidence interval, 1.62 to 2.06) and 4 (odds ratio, 2.33; 95% confidence interval, 1.92 to 2.83 both P<0.001). The stroke risk, in contrast, was lower for patients with CKD stages 4 (odds ratio, 0.23; 95% confidence interval, 0.16 to 0.33) and 5 (odds ratio, 0.24; 95% confidence interval, 0.15 to 0.39; both P<0.001). Lengths of hospital stay were, on average, 1.2-fold longer, whereas reimbursements were, on average, only 1.03-fold higher in patients who suffered from CKD | ||
| 520 | |a CONCLUSIONS: This analysis illustrates for the first time on a nationwide basis the association of CKD with adverse outcomes in patients who underwent transcatheter aortic valve implantation. Thus, classification of CKD stages before transcatheter aortic valve implantation is important for appropriate risk stratification | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Acute Kidney Injury | |
| 650 | 4 | |a Aortic Valve Stenosis | |
| 650 | 4 | |a Comorbidity | |
| 650 | 4 | |a Confidence Intervals | |
| 650 | 4 | |a Economics | |
| 650 | 4 | |a Female | |
| 650 | 4 | |a Germany | |
| 650 | 4 | |a Hospital Mortality | |
| 650 | 4 | |a Humans | |
| 650 | 4 | |a Length of Stay | |
| 650 | 4 | |a Peripheral Arterial Disease | |
| 650 | 4 | |a Prognosis | |
| 650 | 4 | |a Renal Insufficiency, Chronic | |
| 650 | 4 | |a Risk Assessment | |
| 650 | 4 | |a Stroke | |
| 650 | 4 | |a Transcatheter Aortic Valve Replacement | |
| 650 | 4 | |a Treatment Outcome | |
| 650 | 4 | |a chronic renal insufficiency | |
| 650 | 4 | |a coronary artery disease | |
| 650 | 4 | |a diabetes mellitus | |
| 650 | 4 | |a heart failure | |
| 700 | 1 | |a Kaier, Klaus |e verfasserin |4 aut | |
| 700 | 1 | |a Kaleschke, Gerrit |e verfasserin |4 aut | |
| 700 | 1 | |a Gebauer, Katrin |e verfasserin |4 aut | |
| 700 | 1 | |a Meyborg, Matthias |e verfasserin |4 aut | |
| 700 | 1 | |a Malyar, Nasser M |e verfasserin |4 aut | |
| 700 | 1 | |a Freisinger, Eva |e verfasserin |4 aut | |
| 700 | 1 | |a Baumgartner, Helmut |e verfasserin |4 aut | |
| 700 | 1 | |a Reinecke, Holger |e verfasserin |4 aut | |
| 700 | 1 | |a Reinöhl, Jochen |e verfasserin |4 aut | |
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