Circ: Cardiovasc Inte:肾病患者经导管二尖瓣修复术后的结局

2019-02-27 xiangting MedSci原创

大多数接受MitraClip治疗的患者有肾病。

尽管按照指南指导的心血管疗法,肾病仍与预后不良有关,并且该人群中不同性别的结局仍不确定。

评估国家心血管数据登记处经导管瓣膜治疗登记中接受MitraClip手术患者(n=5213)全因死亡率、卒中和肌酐清除率(CrCl)透析新需求的主要复合结局。63%的患者(n=3300)有可用的医疗保险和医疗补助服务中心相关数据。队列中77%的患者(n=4010)CrCl<60mL/min,23%(n=1183)<30mL/min。与CrCl>60mL/min相比,低CrCl患者的主要结局发生率较高(>60mL/min,1.4%; 30-<60mL/min,2.7%;<30mL/min,5.2%;透析,7.8%; P<0.001),并且所有低CrCl组与主要结局独立相关(30-<60mL/min:调整后的比值比,2.32; 95%CI,1.38-3.91; <30mL/min:调整后的比值比,4.44 ; 95%CI,2.63-7.49;透析:调整的危险比,4.52; 95%CI,2.08-9.82)。与CrCl>60mL/min相比,低CrCl的1年死亡率较高(>60mL/min,13.2%; 30-<60mL/min,18.8%; <30mL/min,29.9%;透析,32.3%; P<0.001),所有低CrCl组与1年死亡率独立相关(30-<60mL/min:调整后的危险比,1.50; 95%CI,1.13-1.99;<30mL/min:调整后的危险比,2.38; 95% CI, 1.78-3.20;透析:调整后的危险比,2.44; 95%CI,1.66-3.57)。

大多数接受MitraClip治疗的患者有肾病。术前肾病与预后不良有关,尤其是4期或5期肾病,其中近三分之一的患者在1年内死亡。有必要开展研究以确定如何进一步优化这类人群的结局。

原始出处:

Binita Shah. Outcomes After Transcatheter Mitral Valve Repair in Patients With Renal Disease. Circ: Cardiovascular Interventions. 01 February 2019.

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    2019-12-19 quxin068
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    2019-03-01 wwzzly
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    2019-03-01 lsj631
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    2019-02-28 医者仁心5538

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    2019-02-28 衣带渐宽

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