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经皮左心耳封堵

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Atrial Fibrillation: JACC Council Perspectives Initial Worldwide Experience With the WATCHMAN Left Atrial Appendage System for Stroke Prevention in Atrial Fibrillation Percutaneous Left Atrial Appendage Transcatheter Occlusion (PLAATO System) to Prevent Stroke in High-Risk Patients With Non-Rheumatic Atrial Fibrillation: Results From the International Multi-Center Feasibility Trials Percutaneous left atrial appendage occlusion: the Munich consensus document on definitions, endpoints, and data collection requirements for clinical studies Percutaneous Closure of the Left Atrial Appendage Versus Warfarin Therapy for Prevention of Stroke in Patients With Atrial Fibrillation: A Randomised Non-Inferiority Trial An artificial intelligence-enabled ECG algorithm for the identification of patients with atrial fibrillation during sinus rhythm: a retrospective analysis of outcome prediction Short-Term Oral Anticoagulation Versus Antiplatelet Therapy Following Transcatheter Left Atrial Appendage Closure Percutaneous Left Atrial Appendage Occlusion for Patients in Atrial Fibrillation Suboptimal for Warfarin Therapy: 5-year Results of the PLAATO (Percutaneous Left Atrial Appendage Transcatheter Occlusion) Study Ablation Versus Drug Therapy for Atrial Fibrillation in Heart Failure Results From the CABANA Trial 2020 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants: A Report of the American College of Cardiology Solution Set Oversight Committee
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Original Research2021 Jan 14;S0002-8703(21)00011-9.

JOURNAL:Am Heart J. Article Link

Late kidney injury after transcatheter aortic valve replacement

Y Adachi, M Yamamoto, OCEAN-TAVI investigators et al. Keywords: late kidney injury; TAVR; clinical outcome

ABSTRACT

BACKGROUND - Information on early to late-phase kidney damage in patients who underwent transcatheter aortic valve replacement (TAVR) is scarce. We aimed to identify the predictive factors for late kidney injury (LKI) at 1-year and patient prognosis beyond 1-year after TAVR.

 

METHODS - We retrospectively reviewed 1705 patientsdata from the Japanese TAVR multicenter registry. Acute kidney injury (AKI) and LKI, defined as an increase of at least 0.3 mg/dl in creatinine level, a relative 50% decrease in kidney function from baseline to 48-hours and 1-year, were evaluated. The patients were categorized into the four groups as AKI- /LKI- (n=1362), AKI+ /LKI- (n=95), AKI- /LKI+ (n=199), and AKI+ /LKI+ (n=46).

 

RESULTS - The cumulative 3-year mortality rates were significantly increased across the four groups (12.5%, 15.8%, 24.6%, 25.8%, p<0.001). Multivariate analysis revealed that chronic kidney disease, coronary artery disease, peri-procedural AKI, and heart failure-related re-admission within 1-year were significantly associated with LKI. The Cox regression analysis revealed that AKI- /LKI+ and AKI+ /LKI+ were independent predictors of increased late mortality beyond 1-year after TAVR (p=0.001 and p=0.01).

 

CONCLUSION - LKI was influenced by adverse cardio-renal events and was associated with increased risks of late mortality beyond 1-year after TAVR.