Dataset Information

Prognostic Value of Chronic Kidney Disease in Patients Undergoing Left Atrial Appendage Occlusion.

ABSTRACT:

Background and aims

Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist and share an increased risk of thromboembolism (TE). CKD concomitantly predisposes towards a pro-haemorrhagic state.Our aim was to evaluate the prognostic value of CKD in patients undergoing percutaneous left atrial appendage occlusion (LAAO).

Methods

2124 consecutive AF patients undergoing LAAO were categorized into CKD stage 1+2 (n=1089), CKD stage 3 (n=796), CKD stage 4 (n=170), CKD stage 5 (n=69) based on the estimated glomerular filtration rate at baseline. The primary endpoint included cardiovascular (CV) mortality, TE, and major bleeding. The expected annual TE and major bleeding risks were estimated based on the CHA2DS2-VASc and HAS-BLED scores.

Results

A non-significant higher incidence of major peri-procedural adverse events (1.7% vs. 2.3% vs. 4.1% vs. 4.3%) was observed with worsening CKD (p=0.14). The mean follow-up period was 13 ± 7 months [2226 patient-years]. In comparison to CKD stage 1+2 as a reference, the incidence of the primary endpoint was significantly higher in CKD stage 3 (log-rank p-value= 0.04), CKD stage 4 (log-rank p-value= 0.01), and CKD stage 5 (log-rank p-value= 0.001). LAAO led to a TE risk reduction (RR) of 72%, 66%, 62%, and 41% in each group. The relative RR of major bleeding was 58%, 44%, 51%, and 52%, respectively.

Conclusion

Patients with moderate-to-severe CKD had a higher incidence of the primary composite endpoint. The relative RR in the incidence of TE and major bleeding was consistent across CKD groups.

SUBMITTER: Della Rocca DG

PROVIDER: S-EPMC10653166 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

Prognostic value of chronic kidney disease in patients undergoing left atrial appendage occlusion.

Della Rocca Domenico G DG Magnocavallo Michele M Van Niekerk Christoffel J CJ Gilhofer Thomas T Ha Grace G D'Ambrosio Gabriele G Mohanty Sanghamitra S Gianni Carola C Galvin Jennifer J Vetta Giampaolo G Lavalle Carlo C Di Biase Luigi L Sorgente Antonio A Chierchia Gian-Battista GB de Asmundis Carlo C Urbanek Lukas L Schmidt Boris B Geller J Christoph JC Lakkireddy Dhanunjaya R DR Mansour Moussa M Saw Jacqueline J Horton Rodney P RP Gibson Douglas D Natale Andrea A

Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology 20231101 11

<h4>Aims</h4>Atrial fibrillation (AF) and chronic kidney disease (CKD) often coexist and share an increased risk of thrombo-embolism (TE). CKD concomitantly predisposes towards a pro-haemorrhagic state. Our aim was to evaluate the prognostic value of CKD in patients undergoing percutaneous left atrial appendage occlusion (LAAO).<h4>Methods and results</h4>A total of 2124 consecutive AF patients undergoing LAAO were categorized into CKD stage 1+2 (n = 1089), CKD stage 3 (n = 796), CKD stage 4 (n ...[more]

PMID: 37889200

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