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

ACCESS DATA

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:BackgroundMore than 40% of left atrial appendage closure (LAAC) procedures were combined with atrial fibrillation (AF) ablation in China.ObjectivesThis study aimed to assess the sex differences in the combined radiofrequency catheter ablation and LAAC procedures.MethodsData from the LAACablation (Left Atrial Appendage Closure in Combination With Catheter Ablation) registry, which enrolled AF patients who underwent the combined procedure between 2018 and 2021, were analyzed. Procedural complications, long-term outcomes, and quality of life (QoL) were compared between sexes.ResultsOf 931 patients, 402 (43.2%) were women. Compared with men, women were older (age 71.3 ± 7.4 years vs 68.7 ± 8.1 years; P < 0.001), presented more often with paroxysmal AF (52.5% vs 42.7%; P < 0.003), and had higher CHA2DS2-VASc scores (4.1 ± 1.5 vs 3.1 ± 1.5; P < 0.001), but received less often linear ablation and had shorter total procedural times and radiofrequency catheter ablation times. Women had similar rates of total and major procedural complications but presented with a higher incidence of minor complications than men (3.7% vs 1.3%; P = 0.027). Follow-up over 1,812 patient-years revealed similar adverse events between women and men, including all-cause death (HR: 0.89; 95% CI: 0.43-1.85; P = 0.754), thromboembolic events (HR: 1.17; 95% CI: 0.54-2.52; P = 0.697), major bleeding (HR: 0.96; 95% CI: 0.38-2.44; P = 0.935), and their composite (HR: 0.85; 95% CI: 0.56-1.28; P = 0.434). The recurrence rates of atrial tachyarrhythmia were also comparable between sexes presenting either paroxysmal or persistent AF. Women were seen with greater QoL impairment at baseline, but the sex gap narrowed at 1-year follow-up.ConclusionsIn AF patients who underwent the combined procedure, women had similar procedural safety and long-term efficacy to men and presented greater QoL improvement. (Left Atrial Appendage Closure in Combination With Catheter Ablation [LAACablation]; NCT03788941).

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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