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End-stage renal disease, calcification patterns and clinical outcomes after TAVI

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End-stage renal disease, calcification patterns and clinical outcomes after TAVI. / Grundmann, David; Linder, Matthias; Goßling, Alina; Voigtländer, Lisa; Ludwig, Sebastian; Waldschmidt, Lara; Demal, Till; Bhadra, Oliver D; Schäfer, Andreas; Schirmer, Johannes; Reichenspurner, Hermann; Blankenberg, Stefan; Westermann, Dirk; Schofer, Niklas; Conradi, Lenard; Seiffert, Moritz.

In: CLIN RES CARDIOL, Vol. 111, No. 12, 12.2022, p. 1313-1324.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Grundmann, D, Linder, M, Goßling, A, Voigtländer, L, Ludwig, S, Waldschmidt, L, Demal, T, Bhadra, OD, Schäfer, A, Schirmer, J, Reichenspurner, H, Blankenberg, S, Westermann, D, Schofer, N, Conradi, L & Seiffert, M 2022, 'End-stage renal disease, calcification patterns and clinical outcomes after TAVI', CLIN RES CARDIOL, vol. 111, no. 12, pp. 1313-1324. https://doi.org/10.1007/s00392-021-01968-y

APA

Grundmann, D., Linder, M., Goßling, A., Voigtländer, L., Ludwig, S., Waldschmidt, L., Demal, T., Bhadra, O. D., Schäfer, A., Schirmer, J., Reichenspurner, H., Blankenberg, S., Westermann, D., Schofer, N., Conradi, L., & Seiffert, M. (2022). End-stage renal disease, calcification patterns and clinical outcomes after TAVI. CLIN RES CARDIOL, 111(12), 1313-1324. https://doi.org/10.1007/s00392-021-01968-y

Vancouver

Grundmann D, Linder M, Goßling A, Voigtländer L, Ludwig S, Waldschmidt L et al. End-stage renal disease, calcification patterns and clinical outcomes after TAVI. CLIN RES CARDIOL. 2022 Dec;111(12):1313-1324. https://doi.org/10.1007/s00392-021-01968-y

Bibtex

@article{2ac6583e0d3c49798921f76b9dbfe3a3,
title = "End-stage renal disease, calcification patterns and clinical outcomes after TAVI",
abstract = "BACKGROUND: Patients with chronic hemodialysis due to end-stage renal disease (ESRD) or severely impaired kidney function (CKD) constitute a relevant share of patients undergoing trans-catheter aortic valve implantation (TAVI). However, data on specific challenges and outcomes remain limited.AIM: We aimed to characterize this patient population, evaluate clinical results and assess the significance of calcification patterns.METHODS: This retrospective single-center analysis evaluated 2,712 TAVI procedures (2012-2019) according to baseline renal function: GFR < 30 ml/min/1.73m2 (CKD; n = 210), chronic hemodialysis (ESRD; n = 119) and control (CTRL; n = 2383). Valvular and vascular calcification patterns were assessed from contrast-enhanced multi-detector computed tomography. Outcomes were evaluated in accordance with the VARC-2 definitions.RESULTS: Operative risk was higher in ESRD and CKD vs. CTRL (STS-score 8.4% and 7.6% vs. 3.9%, p < 0.001) and patients with ESRD had more severe vascular calcifications (49.1% vs. 33.9% and 29.0%, p < 0.01). Immediate procedural results were similar but non-procedure-related major/life-threatening bleeding was higher in ESRD and CKD (5.0% and 5.3% vs. 1.6%, p < 0.01). 3-year survival was impaired in patients with ESRD and CKD (33.3% and 35.3% vs. 65.4%, p < 0.001). Multivariable analysis identified ESRD (HR 1.60), CKD (HR 1.79) and vascular calcifications (HR 1.29) as predictors for 3-year and vascular calcifications (HR 1.51) for 30-day mortality.CONCLUSION: Patients with ESRD and CKD constitute a vulnerable patient group with extensive vascular calcifications. Immediate procedural results were largely unaffected by renal impairment, yielding TAVI a particularly valuable treatment option in these high-risk operative patients. Mid-term survival was determined by underlying renal disease, cardiovascular comorbidities, and vascular calcifications as a novel risk marker.",
author = "David Grundmann and Matthias Linder and Alina Go{\ss}ling and Lisa Voigtl{\"a}nder and Sebastian Ludwig and Lara Waldschmidt and Till Demal and Bhadra, {Oliver D} and Andreas Sch{\"a}fer and Johannes Schirmer and Hermann Reichenspurner and Stefan Blankenberg and Dirk Westermann and Niklas Schofer and Lenard Conradi and Moritz Seiffert",
note = "{\textcopyright} 2021. The Author(s).",
year = "2022",
month = dec,
doi = "10.1007/s00392-021-01968-y",
language = "English",
volume = "111",
pages = "1313--1324",
journal = "CLIN RES CARDIOL",
issn = "1861-0684",
publisher = "D. Steinkopff-Verlag",
number = "12",

}

RIS

TY - JOUR

T1 - End-stage renal disease, calcification patterns and clinical outcomes after TAVI

AU - Grundmann, David

AU - Linder, Matthias

AU - Goßling, Alina

AU - Voigtländer, Lisa

AU - Ludwig, Sebastian

AU - Waldschmidt, Lara

AU - Demal, Till

AU - Bhadra, Oliver D

AU - Schäfer, Andreas

AU - Schirmer, Johannes

AU - Reichenspurner, Hermann

AU - Blankenberg, Stefan

AU - Westermann, Dirk

AU - Schofer, Niklas

AU - Conradi, Lenard

AU - Seiffert, Moritz

N1 - © 2021. The Author(s).

PY - 2022/12

Y1 - 2022/12

N2 - BACKGROUND: Patients with chronic hemodialysis due to end-stage renal disease (ESRD) or severely impaired kidney function (CKD) constitute a relevant share of patients undergoing trans-catheter aortic valve implantation (TAVI). However, data on specific challenges and outcomes remain limited.AIM: We aimed to characterize this patient population, evaluate clinical results and assess the significance of calcification patterns.METHODS: This retrospective single-center analysis evaluated 2,712 TAVI procedures (2012-2019) according to baseline renal function: GFR < 30 ml/min/1.73m2 (CKD; n = 210), chronic hemodialysis (ESRD; n = 119) and control (CTRL; n = 2383). Valvular and vascular calcification patterns were assessed from contrast-enhanced multi-detector computed tomography. Outcomes were evaluated in accordance with the VARC-2 definitions.RESULTS: Operative risk was higher in ESRD and CKD vs. CTRL (STS-score 8.4% and 7.6% vs. 3.9%, p < 0.001) and patients with ESRD had more severe vascular calcifications (49.1% vs. 33.9% and 29.0%, p < 0.01). Immediate procedural results were similar but non-procedure-related major/life-threatening bleeding was higher in ESRD and CKD (5.0% and 5.3% vs. 1.6%, p < 0.01). 3-year survival was impaired in patients with ESRD and CKD (33.3% and 35.3% vs. 65.4%, p < 0.001). Multivariable analysis identified ESRD (HR 1.60), CKD (HR 1.79) and vascular calcifications (HR 1.29) as predictors for 3-year and vascular calcifications (HR 1.51) for 30-day mortality.CONCLUSION: Patients with ESRD and CKD constitute a vulnerable patient group with extensive vascular calcifications. Immediate procedural results were largely unaffected by renal impairment, yielding TAVI a particularly valuable treatment option in these high-risk operative patients. Mid-term survival was determined by underlying renal disease, cardiovascular comorbidities, and vascular calcifications as a novel risk marker.

AB - BACKGROUND: Patients with chronic hemodialysis due to end-stage renal disease (ESRD) or severely impaired kidney function (CKD) constitute a relevant share of patients undergoing trans-catheter aortic valve implantation (TAVI). However, data on specific challenges and outcomes remain limited.AIM: We aimed to characterize this patient population, evaluate clinical results and assess the significance of calcification patterns.METHODS: This retrospective single-center analysis evaluated 2,712 TAVI procedures (2012-2019) according to baseline renal function: GFR < 30 ml/min/1.73m2 (CKD; n = 210), chronic hemodialysis (ESRD; n = 119) and control (CTRL; n = 2383). Valvular and vascular calcification patterns were assessed from contrast-enhanced multi-detector computed tomography. Outcomes were evaluated in accordance with the VARC-2 definitions.RESULTS: Operative risk was higher in ESRD and CKD vs. CTRL (STS-score 8.4% and 7.6% vs. 3.9%, p < 0.001) and patients with ESRD had more severe vascular calcifications (49.1% vs. 33.9% and 29.0%, p < 0.01). Immediate procedural results were similar but non-procedure-related major/life-threatening bleeding was higher in ESRD and CKD (5.0% and 5.3% vs. 1.6%, p < 0.01). 3-year survival was impaired in patients with ESRD and CKD (33.3% and 35.3% vs. 65.4%, p < 0.001). Multivariable analysis identified ESRD (HR 1.60), CKD (HR 1.79) and vascular calcifications (HR 1.29) as predictors for 3-year and vascular calcifications (HR 1.51) for 30-day mortality.CONCLUSION: Patients with ESRD and CKD constitute a vulnerable patient group with extensive vascular calcifications. Immediate procedural results were largely unaffected by renal impairment, yielding TAVI a particularly valuable treatment option in these high-risk operative patients. Mid-term survival was determined by underlying renal disease, cardiovascular comorbidities, and vascular calcifications as a novel risk marker.

U2 - 10.1007/s00392-021-01968-y

DO - 10.1007/s00392-021-01968-y

M3 - SCORING: Journal article

C2 - 34773135

VL - 111

SP - 1313

EP - 1324

JO - CLIN RES CARDIOL

JF - CLIN RES CARDIOL

SN - 1861-0684

IS - 12

ER -