Transcatheter left atrial appendage occlusion in patients with chronic kidney disease: a systematic review and meta-analysis

Flores-Umanzor, Eduardo; Asghar, Areeba; Cepas-Guillén, Pedro L.; Farrell, Ashley; Keshvara, Rajesh; Alvarez-Rodriguez, Leyre; Osten, Mark; Freixa, Xavier; Horlick, Eric; Abrahamyan, Lusine

doi:10.1007/s00392-023-02359-1

Cited by 3 publications

(3 citation statements)

References 63 publications

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“…Moreover, the follow-up duration ranged from 90 to 777 days, and there were differences in the definition of bleeding events across studies. 5 The present paper focalizes on patients with eGFR <30 mL/min/1.73 m 2 , usually underrepresented in trials on oral anticoagulation and in most of the studies. Furthermore, authors extend the analysis to a long-term follow-up (up to 5 years).…”

Section: Key Pointsmentioning

confidence: 99%

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Left atrial appendage closure and advanced chronic kidney disease: Another string to the bow

D'Amico,

Gallo

2024

Cathet Cardio Intervent

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Key points Patients with severe chronic kidney disease (CKD) and nonvalvular atrial fibrillation are underrepresented in left atrial appendage occlusion (LAAO) studies, despite their higher fragility and greater intolerance to antithrombotic therapy. LAAO appears to be safe and effective in reducing thromboembolic and bleeding recurrences both in patients with and without advanced CKD. Despite favorable ischemic and bleeding outcomes, patients with severe CKD experienced higher mortality rate, compared to those without severe CKD

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Section: Key Pointsmentioning

confidence: 99%

“…There are no randomized trials of LAAO in subjects with CKD, and the vast majority of data come from retrospective registries, 5 showing no significant differences between CKD and non-CKD Expert Article Analysis for: Left atrial appendage occlusion in patients suffering from advanced chronic kidney disease (stage 4 and 5). Long-term follow-up…”

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confidence: 99%

Left atrial appendage closure and advanced chronic kidney disease: Another string to the bow

D'Amico,

Gallo

2024

Cathet Cardio Intervent

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“…Besides common risk factors for heart failure such as advancing age, diabetes mellitus, hypertension, and coronary heart disease, chronic volume overload, poorly controlled hypertension, and uremic toxins may have a negative impact on myocardial contractility and function [ 1 , 7 ]. Chronic kidney disease is also a risk factor for embolic stroke [ 8 , 9 , 10 ]. Therefore, it is essential to understand the burden of CVD and to provide appropriate management of CVD for this population.…”

Section: Introductionmentioning

confidence: 99%

The Burden of Cardiovascular Disease and Geriatric Syndromes in Older Patients Undergoing Chronic Hemodialysis

Nguyen,

Pham,

Nguyen

2024

IJERPH

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Background. There is limited evidence on the complexity of cardiovascular disease (CVD) and geriatric syndromes in older patients with end-stage renal disease. Our aims were to (1) examine the prevalence of CVD in older patients on chronic hemodialysis, (2) compare the burden of geriatric syndromes in patients with and without CVD, and (3) examine the impact of CVD on hospitalization. Methods. This prospective, observational, multi-center study was conducted at two dialysis units of two major hospitals in Vietnam. Consecutive older adults receiving chronic hemodialysis were recruited from November 2020 to June 2021. CVD was defined as having one of these conditions: heart failure, ischemic heart disease, or stroke. Participants were assessed for geriatric conditions including frailty, malnutrition, impairment in instrumental activities/activities of daily living, depression, falls, and polypharmacy. Multivariable logistic regression analysis was applied to examine the impact of CVD on 6-month hospitalization, adjusting for age, sex, duration of dialysis, Charlson Comorbidity Index, and geriatric conditions. Results were presented as odds ratios (ORs) and 95% confidence intervals (CIs). Results. There were 175 participants (mean age 72.4 ± 8.5 and 58.9% female). CVD was present in 80% of the participants (ischemic heart disease: 49.7%, heart failure: 60.0%, and stroke: 25.7%). Participants with CVD had a higher burden of geriatric syndromes compared to those without CVD. During the 6-month follow-up, 48.6% of the participants were hospitalized (56.4% of those with CVD vs. 17.1% of those without CVD), p < 0.001). CVD independently increased the risk of hospitalization (adjusted OR 3.32, 95% CI 1.12–9.80). Conclusions. In this study, there was a very high prevalence of CVD in older patients undergoing chronic dialysis. Participants with CVD had a higher burden of geriatric syndromes and their risk of 6-month hospitalization increased by three times. There is a need for a multidisciplinary and patient-centered approach to treatment planning for these patients.

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Zero-contrast left atrial appendage closure, a feasible alternative for patients with a high risk of contrast-induced nephropathy: Systematic literature review and meta-analysis

Rodriguez,

Pachón-Londoño,

Areiza

et al. 2024

Heart Rhythm

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Transcatheter left atrial appendage occlusion in patients with chronic kidney disease: a systematic review and meta-analysis

Cited by 3 publications

References 63 publications

Left atrial appendage closure and advanced chronic kidney disease: Another string to the bow

Left atrial appendage closure and advanced chronic kidney disease: Another string to the bow

The Burden of Cardiovascular Disease and Geriatric Syndromes in Older Patients Undergoing Chronic Hemodialysis

Zero-contrast left atrial appendage closure, a feasible alternative for patients with a high risk of contrast-induced nephropathy: Systematic literature review and meta-analysis

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