Impact of Renal Function on Survival After Cardiac Resynchronization Therapy
Chronic kidney disease (CKD) is associated with worse survival in patients with heart disease including those with implantable devices. Cardiac resynchronization therapy (CRT) can potentially improve renal function. To assess the relation between the change in renal function and survival with CRT, 2...
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| Veröffentlicht in: | The American journal of cardiology 2017-07, Vol.120 (2), p.262-266 |
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| creator | Kpaeyeh, J. Alvin Divoky, Laura Hyer, J. Madison Daly, David D. Maran, Anbukarasi Waring, Ashley Gold, Michael R. |
| description | Chronic kidney disease (CKD) is associated with worse survival in patients with heart disease including those with implantable devices. Cardiac resynchronization therapy (CRT) can potentially improve renal function. To assess the relation between the change in renal function and survival with CRT, 238 patients undergoing initial CRT with defibrillator implantation between 2002 and 2011 were followed. The primary end point was all-cause mortality. The estimated glomerular filtration rate (eGFR), before implantation and 6 ± 3 months after CRT was calculated. Patients were grouped at baseline into mild (stage I/II) or advanced (stage III/IV) CKD. Patients with end-stage renal disease were excluded. The mean follow-up time was 4.3 years. Multivariate analysis of baseline clinical characteristics showed that only renal function predicted the change in eGFR over the first 6 months of CRT. In the subgroup with mild CKD, eGFR decreased (78.5 ± 17.3 to 67.8 ± 26.8 p |
| doi_str_mv | 10.1016/j.amjcard.2017.04.017 |
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Alvin ; Divoky, Laura ; Hyer, J. Madison ; Daly, David D. ; Maran, Anbukarasi ; Waring, Ashley ; Gold, Michael R.</creator><creatorcontrib>Kpaeyeh, J. Alvin ; Divoky, Laura ; Hyer, J. Madison ; Daly, David D. ; Maran, Anbukarasi ; Waring, Ashley ; Gold, Michael R.</creatorcontrib><description>Chronic kidney disease (CKD) is associated with worse survival in patients with heart disease including those with implantable devices. Cardiac resynchronization therapy (CRT) can potentially improve renal function. To assess the relation between the change in renal function and survival with CRT, 238 patients undergoing initial CRT with defibrillator implantation between 2002 and 2011 were followed. The primary end point was all-cause mortality. The estimated glomerular filtration rate (eGFR), before implantation and 6 ± 3 months after CRT was calculated. Patients were grouped at baseline into mild (stage I/II) or advanced (stage III/IV) CKD. Patients with end-stage renal disease were excluded. The mean follow-up time was 4.3 years. Multivariate analysis of baseline clinical characteristics showed that only renal function predicted the change in eGFR over the first 6 months of CRT. In the subgroup with mild CKD, eGFR decreased (78.5 ± 17.3 to 67.8 ± 26.8 p <0.001), whereas eGFR did not change in the subgroup with advanced CKD (45.6 ± 11.1 to 46.8 ± 17.0, p = 0.46). Patients with advanced CKD had higher mortality than those with mild CKD (p <0.002). In both subgroups, an increase in eGFR was associated with improved survival (hazard ratio = 0.79, p <0.001). In conclusion, baseline renal function and the subsequent change in eGFR are associated with long-term survival with CRT.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2017.04.017</identifier><identifier>PMID: 28545627</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Aged ; Beta blockers ; Cardiac Resynchronization Therapy - methods ; Cardiovascular disease ; Cause of Death - trends ; Coronary artery disease ; Defibrillators ; End-stage renal disease ; Epidermal growth factor receptors ; Female ; Follow-Up Studies ; Glomerular filtration rate ; Glomerular Filtration Rate - physiology ; Health risk assessment ; Heart ; Heart diseases ; Heart Failure - complications ; Heart Failure - mortality ; Heart Failure - therapy ; Humans ; Implantation ; Incidence ; Kidney - physiopathology ; Kidney diseases ; Kidney Function Tests ; Kidney transplantation ; Male ; Mathematical analysis ; Middle Aged ; Mortality ; Multivariate analysis ; Patients ; Prognosis ; Renal function ; Renal Insufficiency, Chronic - complications ; Renal Insufficiency, Chronic - epidemiology ; Renal Insufficiency, Chronic - physiopathology ; Retrospective Studies ; Risk Factors ; South Carolina - epidemiology ; Subgroups ; Survival ; Therapy ; Time Factors</subject><ispartof>The American journal of cardiology, 2017-07, Vol.120 (2), p.262-266</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright © 2017 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Jul 15, 2017</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c459t-6b041f8b33794421cc811ad247cc8fe6269b857f0596ffd7d2efc684d46875503</citedby><cites>FETCH-LOGICAL-c459t-6b041f8b33794421cc811ad247cc8fe6269b857f0596ffd7d2efc684d46875503</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1911184448?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28545627$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kpaeyeh, J. Alvin</creatorcontrib><creatorcontrib>Divoky, Laura</creatorcontrib><creatorcontrib>Hyer, J. Madison</creatorcontrib><creatorcontrib>Daly, David D.</creatorcontrib><creatorcontrib>Maran, Anbukarasi</creatorcontrib><creatorcontrib>Waring, Ashley</creatorcontrib><creatorcontrib>Gold, Michael R.</creatorcontrib><title>Impact of Renal Function on Survival After Cardiac Resynchronization Therapy</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Chronic kidney disease (CKD) is associated with worse survival in patients with heart disease including those with implantable devices. Cardiac resynchronization therapy (CRT) can potentially improve renal function. To assess the relation between the change in renal function and survival with CRT, 238 patients undergoing initial CRT with defibrillator implantation between 2002 and 2011 were followed. The primary end point was all-cause mortality. The estimated glomerular filtration rate (eGFR), before implantation and 6 ± 3 months after CRT was calculated. Patients were grouped at baseline into mild (stage I/II) or advanced (stage III/IV) CKD. Patients with end-stage renal disease were excluded. The mean follow-up time was 4.3 years. Multivariate analysis of baseline clinical characteristics showed that only renal function predicted the change in eGFR over the first 6 months of CRT. In the subgroup with mild CKD, eGFR decreased (78.5 ± 17.3 to 67.8 ± 26.8 p <0.001), whereas eGFR did not change in the subgroup with advanced CKD (45.6 ± 11.1 to 46.8 ± 17.0, p = 0.46). Patients with advanced CKD had higher mortality than those with mild CKD (p <0.002). In both subgroups, an increase in eGFR was associated with improved survival (hazard ratio = 0.79, p <0.001). In conclusion, baseline renal function and the subsequent change in eGFR are associated with long-term survival with CRT.</description><subject>Aged</subject><subject>Beta blockers</subject><subject>Cardiac Resynchronization Therapy - methods</subject><subject>Cardiovascular disease</subject><subject>Cause of Death - trends</subject><subject>Coronary artery disease</subject><subject>Defibrillators</subject><subject>End-stage renal disease</subject><subject>Epidermal growth factor receptors</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular filtration rate</subject><subject>Glomerular Filtration Rate - physiology</subject><subject>Health risk assessment</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Heart Failure - complications</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - therapy</subject><subject>Humans</subject><subject>Implantation</subject><subject>Incidence</subject><subject>Kidney - physiopathology</subject><subject>Kidney diseases</subject><subject>Kidney Function Tests</subject><subject>Kidney transplantation</subject><subject>Male</subject><subject>Mathematical analysis</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Multivariate analysis</subject><subject>Patients</subject><subject>Prognosis</subject><subject>Renal function</subject><subject>Renal Insufficiency, Chronic - complications</subject><subject>Renal Insufficiency, Chronic - epidemiology</subject><subject>Renal Insufficiency, Chronic - physiopathology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>South Carolina - epidemiology</subject><subject>Subgroups</subject><subject>Survival</subject><subject>Therapy</subject><subject>Time Factors</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkE1r4zAQhsWyZZOm-xNaDHvZi12NLMnSaQlh-wGBQpuehSJLVCa2s5IdSH99lSbbQy8FwasRz8ygB6FLwAVg4NdNodvG6FAXBENVYFqk-IamICqZg4TyO5pijEkugcoJOo-xSSUA4z_QhAhGGSfVFC3v2602Q9a77NF2epPdjJ0ZfN9l6TyNYed36XHuBhuyRdrmtUlg3HfmJfSdf9Xv7OrFBr3dX6AzpzfR_jzlDD3f_F0t7vLlw-39Yr7MDWVyyPkaU3BiXZaVpJSAMQJA14RW6eYsJ1yuBascZpI7V1c1sc5wQWvKRcUYLmfo93HuNvT_RhsH1fpo7GajO9uPUYHEJXApBEnor09o048hffRAAYCglIpEsSNlQh9jsE5tg2912CvA6qBbNeqkWx10K0xVitR3dZo-rltbf3T995uAP0fAJh07b4OKxtvO2NoHawZV9_6LFW90J5Hq</recordid><startdate>20170715</startdate><enddate>20170715</enddate><creator>Kpaeyeh, J. Alvin</creator><creator>Divoky, Laura</creator><creator>Hyer, J. 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Alvin</au><au>Divoky, Laura</au><au>Hyer, J. Madison</au><au>Daly, David D.</au><au>Maran, Anbukarasi</au><au>Waring, Ashley</au><au>Gold, Michael R.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Renal Function on Survival After Cardiac Resynchronization Therapy</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2017-07-15</date><risdate>2017</risdate><volume>120</volume><issue>2</issue><spage>262</spage><epage>266</epage><pages>262-266</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><abstract>Chronic kidney disease (CKD) is associated with worse survival in patients with heart disease including those with implantable devices. Cardiac resynchronization therapy (CRT) can potentially improve renal function. To assess the relation between the change in renal function and survival with CRT, 238 patients undergoing initial CRT with defibrillator implantation between 2002 and 2011 were followed. The primary end point was all-cause mortality. The estimated glomerular filtration rate (eGFR), before implantation and 6 ± 3 months after CRT was calculated. Patients were grouped at baseline into mild (stage I/II) or advanced (stage III/IV) CKD. Patients with end-stage renal disease were excluded. The mean follow-up time was 4.3 years. Multivariate analysis of baseline clinical characteristics showed that only renal function predicted the change in eGFR over the first 6 months of CRT. In the subgroup with mild CKD, eGFR decreased (78.5 ± 17.3 to 67.8 ± 26.8 p <0.001), whereas eGFR did not change in the subgroup with advanced CKD (45.6 ± 11.1 to 46.8 ± 17.0, p = 0.46). Patients with advanced CKD had higher mortality than those with mild CKD (p <0.002). In both subgroups, an increase in eGFR was associated with improved survival (hazard ratio = 0.79, p <0.001). In conclusion, baseline renal function and the subsequent change in eGFR are associated with long-term survival with CRT.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28545627</pmid><doi>10.1016/j.amjcard.2017.04.017</doi><tpages>5</tpages></addata></record> |
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| subjects | Aged Beta blockers Cardiac Resynchronization Therapy - methods Cardiovascular disease Cause of Death - trends Coronary artery disease Defibrillators End-stage renal disease Epidermal growth factor receptors Female Follow-Up Studies Glomerular filtration rate Glomerular Filtration Rate - physiology Health risk assessment Heart Heart diseases Heart Failure - complications Heart Failure - mortality Heart Failure - therapy Humans Implantation Incidence Kidney - physiopathology Kidney diseases Kidney Function Tests Kidney transplantation Male Mathematical analysis Middle Aged Mortality Multivariate analysis Patients Prognosis Renal function Renal Insufficiency, Chronic - complications Renal Insufficiency, Chronic - epidemiology Renal Insufficiency, Chronic - physiopathology Retrospective Studies Risk Factors South Carolina - epidemiology Subgroups Survival Therapy Time Factors |
| title | Impact of Renal Function on Survival After Cardiac Resynchronization Therapy |
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