TY - JOUR
T1 - Renal function and mortality following cardiac resynchronization therapy
AU - Lin, Grace
AU - Gersh, Bernard J.
AU - Greene, Eddie L.
AU - Redfield, Margaret M.
AU - Hayes, David L.
AU - Brady, Peter A.
PY - 2011/1
Y1 - 2011/1
N2 - AimsCardiac resynchronization therapy (CRT) improves outcomes in heart failure, yet selection of patients likely to have survival benefit is problematic. Chronic kidney disease (CKD) is an important determinant of mortality in patients with congestive heart failure therefore we sought to determine the impact of CKD on mortality benefit after CRT.Methods and resultsAll CRT device implantations in patients not on dialysis at Mayo Clinic between January 1999 and December 2005 were included. Of 482 patients, 342 (71) had CKD (defined as a glomerular filtration rate (GFR) of ≤60 mL/min/1.73 m 2) at the time of device implantation. Patients with CKD were older (71 ± 10 vs. 63 ± 14 years, P < 0.01) than patients without CKD, and more often anaemic (12.70 ± 1.73 vs. 13.24 mg/L, P < 0.01), with similar ejection fraction (22 ± 8 vs. 23 ± 8, P 0.32). Survival was superior in patients with normal or mild renal dysfunction compared with patients with CKD (72 vs. 57 at 3 years, P < 0.01). After multivariate analysis, CKD remained a significant predictor of poor survival following CRT.ConclusionChronic kidney disease is common in patients undergoing CRT and associated with a higher mortality and should be considered when evaluating patients for CRT.
AB - AimsCardiac resynchronization therapy (CRT) improves outcomes in heart failure, yet selection of patients likely to have survival benefit is problematic. Chronic kidney disease (CKD) is an important determinant of mortality in patients with congestive heart failure therefore we sought to determine the impact of CKD on mortality benefit after CRT.Methods and resultsAll CRT device implantations in patients not on dialysis at Mayo Clinic between January 1999 and December 2005 were included. Of 482 patients, 342 (71) had CKD (defined as a glomerular filtration rate (GFR) of ≤60 mL/min/1.73 m 2) at the time of device implantation. Patients with CKD were older (71 ± 10 vs. 63 ± 14 years, P < 0.01) than patients without CKD, and more often anaemic (12.70 ± 1.73 vs. 13.24 mg/L, P < 0.01), with similar ejection fraction (22 ± 8 vs. 23 ± 8, P 0.32). Survival was superior in patients with normal or mild renal dysfunction compared with patients with CKD (72 vs. 57 at 3 years, P < 0.01). After multivariate analysis, CKD remained a significant predictor of poor survival following CRT.ConclusionChronic kidney disease is common in patients undergoing CRT and associated with a higher mortality and should be considered when evaluating patients for CRT.
KW - Cardiac resynchronization therapy
KW - Chronic kidney disease
KW - Heart failure
KW - Mortality
UR - http://www.scopus.com/inward/record.url?scp=78651497651&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=78651497651&partnerID=8YFLogxK
U2 - 10.1093/eurheartj/ehq403
DO - 10.1093/eurheartj/ehq403
M3 - Article
C2 - 21068051
AN - SCOPUS:78651497651
SN - 0195-668X
VL - 32
SP - 184
EP - 190
JO - European heart journal
JF - European heart journal
IS - 2
ER -