Dataset Information

Left atrial appendage closure in patients with chronic kidney disease: results from the German multicentre LAARGE registry.

ABSTRACT:

Objectives

Chronic kidney disease (CKD) is associated with an increased complication rate after cardiac interventions. Although CKD has a high prevalence among atrial fibrillation patients, the impact of CKD on periprocedural complications and the outcome after an interventional left atrial appendage closure (LAAC) is unclear. The present study, therefore, aimed to investigate whether CKD influences the procedure's effectiveness and safety.

Methods

LAARGE is a prospective, non-randomised registry. LAAC was conducted with different standard commercial devices, and the follow-up period was one year. CKD was defined by an eGFR?2, and subgroups were further analysed (i.e. eGFR?2, respectively).

Results

Two hundred ninety-nine of 623 patients (48.0%) revealed a CKD. The prevalence of cardiovascular comorbidity, CHA₂DS₂-VASc score (4.9 vs. 4.2), and HAS-BLED score (4.3 vs. 3.5) was significantly higher in CKD patients (each p?2; p > 0.05? vs. eGFR 30-59 mL/min/1.73 m²). Non-fatal strokes were absolutely infrequent during follow-up (0 vs. 1.1%). Severe non-fatal bleedings were observed only among CKD patients (1.4 vs. 0%; p?=?0.021).

Conclusions

Despite an increased cardiovascular risk profile of CKD patients, device implantation was safe, and LAAC was associated with effective stroke prevention across all CKD stages.

SUBMITTER: Fastner C

PROVIDER: S-EPMC7806558 | biostudies-literature | 2021 Jan

REPOSITORIES: biostudies-literature

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Publications

Left atrial appendage closure in patients with chronic kidney disease: results from the German multicentre LAARGE registry.

Fastner Christian C Brachmann Johannes J Lewalter Thorsten T Zeymer Uwe U Sievert Horst H Borggrefe Martin M Nienaber Christoph A CA Weiß Christian C Pleger Sven T ST Ince Hüseyin H Maier Jens J Achenbach Stephan S Sigusch Holger H HH Hochadel Matthias M Schneider Steffen S Senges Jochen J Akin Ibrahim I

Clinical research in cardiology : official journal of the German Cardiac Society 20200415 1

<h4>Objectives</h4>Chronic kidney disease (CKD) is associated with an increased complication rate after cardiac interventions. Although CKD has a high prevalence among atrial fibrillation patients, the impact of CKD on periprocedural complications and the outcome after an interventional left atrial appendage closure (LAAC) is unclear. The present study, therefore, aimed to investigate whether CKD influences the procedure's effectiveness and safety.<h4>Methods</h4>LAARGE is a prospective, non-ran ...[more]

PMID: 32296971

Similar Datasets

Project description:BackgroundLeft atrial appendage occlusion (LAAO) to prevent stroke in patients with atrial fibrillation has been evaluated in 2 randomized trials; post-approval clinical data are limited.ObjectivesThe purpose of this study was to describe the National Cardiovascular Data Registry (NCDR) LAAO Registry and present patient, hospital, and physician characteristics and in-hospital adverse event rates for Watchman procedures in the United States during its first 3 years.MethodsThe authors describe the LAAO Registry structure and governance, the outcome adjudication processes, and the data quality and collection processes. They characterize the patient population, performing hospitals, and in-hospital adverse event rates.ResultsA total of 38,158 procedures from 495 hospitals performed by 1,318 physicians in the United States were included between January 2016 and December 2018. The mean patient age was 76.1 ± 8.1 years, the mean CHA2DS2-VASc (congestive heart failure, hypertension, 65 years of age and older, diabetes mellitus, previous stroke or transient ischemic attack, vascular disease, 65 to 74 years of age, female) score was 4.6 ± 1.5, and the mean HAS-BLED (hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition, labile international normalized ratio, elderly, drugs/alcohol concomitantly) score was 3.0 ± 1.1. The median annual number of LAAO procedures performed for hospitals was 30 (interquartile range: 18 to 44) and for physicians was 12 (interquartile range: 8 to 20). Procedures were canceled or aborted in 7% of cases; among cases in which a device was deployed, 98.1% were implanted with <5-mm leak. Major in-hospital adverse events occurred in 2.16% of patients; the most common complications were pericardial effusion requiring intervention (1.39%) and major bleeding (1.25%), whereas stroke (0.17%) and death (0.19%) were rare.ConclusionsThe LAAO Registry has enrolled >38,000 patients implanted with the device. Patients were generally older with more comorbidities than those enrolled in the pivotal trials; however, major in-hospital adverse event rates were lower than reported in those trials.

Dataset Information

Left atrial appendage closure in patients with chronic kidney disease: results from the German multicentre LAARGE registry.

Objectives

Methods

Results

Conclusions

Publications

Left atrial appendage closure in patients with chronic kidney disease: results from the German multicentre LAARGE registry.

Similar Datasets

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