经过导管大动脉置换后急性损伤的影响:全国性研究
Jeppe Kofoed Petersen1, Lauge Østergaard1, Nicholas Carlson2
1Department of Cardiology Copenhagen University Hospital Rigshospitalet Copenhagen Denmark.
Journal of the American Heart Association
|December 29, 2023
概括
过导管大动脉置换 (TAVR) 后的急性损伤 (AKI) 显著增加了透析和死亡的风险. 然而,大多数幸存者在六个月内实现脏恢复.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 医疗干预 医疗干预
背景情况:
- 急性损伤 (AKI) 是通过导管的大动脉置换 (TAVR) 患者的一个担忧.
- 关于AKI在TAVR后对功能长期影响的数据有限.
- 需要进行大型队列研究,以了解TAVR后的AKI预后.
研究的目的:
- 调查TAVR后AKI和随后的功能之间的关联.
- 评估AKI对透析率和TAVR后死亡率的影响.
- 评估TAVR患者经历AKI的恢复模式.
主要方法:
- 利用丹麦全国性的登记册来识别没有先前透析的TAVR患者 (2014-2021年).
- 根据21天内的肌水平,定义了TAVR后的AKI.
- 使用考克斯分析,在AKI和非AKI组之间比较1年的透析和死亡率.
- 在TAVR后90-180天内评估AKI幸存者的功能.
主要成果:
- 确定了4091个TAVR;193个 (4.7%) 经历了AKI.
- 与非AKI患者相比,AKI患者的透析率 (HR 7.20) 和1年死亡率 (HR 2.39) 显着更高.
- 在6个月的AKI幸存者中,74%的脏完全恢复,14.7%的脏不完全恢复,6.3%没有恢复,5.1%需要透析.
结论:
- 在TAVR后的AKI与未来透析和死亡风险的增加有关.
- 大多数经历AKI的TAVR患者在六个月内实现脏完全恢复.
- AKI是TAVR结果的重要预后因素.
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