Cargando…

Chronic kidney disease impairs prognosis in electrical storm

BACKGROUND: The study sought to assess the prognostic impact of chronic kidney disease (CKD) in patients with electrical storm (ES). ES represents a life-threatening heart rhythm disorder. In particular, CKD patients are at risk of suffering from ES. However, data regarding the prognostic impact of...

Descripción completa

Detalles Bibliográficos
Autores principales: Weidner, Kathrin, Behnes, Michael, Schupp, Tobias, Hoppner, Jorge, Ansari, Uzair, Mueller, Julian, Lindner, Simon, Borggrefe, Martin, Kim, Seung-hyun, Huseyinov, Aydin, Ellguth, Dominik, Akin, Muharrem, Meininghaus, Dirk Große, Bertsch, Thomas, Taton, Gabriel, Bollow, Armin, Reichelt, Thomas, Engelke, Niko, Reiser, Linda, Akin, Ibrahim
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8755690/
https://www.ncbi.nlm.nih.gov/pubmed/33483805
http://dx.doi.org/10.1007/s10840-020-00924-6
Descripción
Sumario:BACKGROUND: The study sought to assess the prognostic impact of chronic kidney disease (CKD) in patients with electrical storm (ES). ES represents a life-threatening heart rhythm disorder. In particular, CKD patients are at risk of suffering from ES. However, data regarding the prognostic impact of CKD on long-term mortality in ES patients is limited. METHODS: All consecutive ES patients with an implantable cardioverter–defibrillator (ICD) were included retrospectively from 2002 to 2016. Patients with CKD (MDRD-GFR < 60 ml/min/1.73 m(2)) were compared to patients without CKD. The primary endpoint was all-cause mortality at 3 years. Secondary endpoints were in-hospital mortality, cardiac rehospitalization, recurrences of electrical storm (ES-R), and major adverse cardiac events (MACE) at 3 years. RESULTS: A total of 70 consecutive ES patients were included. CKD was present in 43% of ES patients with a median glomerular filtration rate (GFR) of 43.3 ml/min/1.73 m(2). CKD was associated with increased all-cause mortality at 3 years (63% vs. 20%; p = 0.001; HR = 4.293; 95% CI 1.874–9.836; p = 0.001) and MACE (57% vs. 30%; p = 0.025; HR = 3.597; 95% CI 1.679–7.708; p = 0.001). In contrast, first cardiac rehospitalization (43% vs. 45%; log-rank p = 0.889) and ES-R (30% vs. 20%; log-rank p = 0.334) were not affected by CKD. Even after multivariable adjustment, CKD was still associated with increased long-term mortality (HR = 2.397; 95% CI 1.012–5.697; p = 0.047), as well as with the secondary endpoint MACE (HR = 2.520; 95% CI 1.109–5.727; p = 0.027). CONCLUSIONS: In patients with ES, the presence of CKD was associated with increased long-term mortality and MACE.