Kathrin Weidner1, Michael Behnes2, Tobias Schupp1, Jonas Rusnak1, Linda Reiser1, Gabriel Taton1, Thomas Reichelt1, Dominik Ellguth1, Niko Engelke1, Armin Bollow1, Ibrahim El-Battrawy1, Uzair Ansari1, Jorge Hoppner3, Christoph A Nienaber4, Kambis Mashayekhi5, Christel Weiß6, Muharrem Akin7, Martin Borggrefe1, Ibrahim Akin1. 1. First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. 2. First Department of Medicine, Faculty of Medicine Mannheim, University Medical Centre Mannheim (UMM), University of Heidelberg, European Center for AngioScience (ECAS), and DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany. michael.behnes@umm.de. 3. Clinic for Diagnostic and Interventional Radiology Heidelberg, University Heidelberg, Heidelberg, Germany. 4. Royal Brompton and Harefield Hospitals, NHS, London, UK. 5. Department of Cardiology and Angiology II, University Heart Center Freiburg, Bad Krozingen, Germany. 6. Institute of Biomathematics and Medical Statistics, Faculty of Medicine Mannheim, University Medical Center Mannheim (UMM), Heidelberg University, Mannheim, Germany. 7. Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
Abstract
BACKGROUND: The study sought to assess the prognostic impact of chronic kidney disease (CKD) and renal replacement therapy (RRT) in patients with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. METHODS: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT), fibrillation (VF) and SCA on admission from 2002 to 2016. Non-CKD vs. "CKD without RRT", and "CKD without RRT" vs. "CKD with RRT" were compared applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint defined as long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index and the composite endpoint of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and cardiac death at 24 h. RESULTS: In 2686 unmatched high-risk patients with ventricular tachyarrhythmias and SCA, non-CKD was present in 46%, "CKD without RRT" in 46% and "CKD with RRT" in 8%. Each, VT and VF occurred in about one-third of CKD patients. Multivariable Cox regression models revealed that "CKD without RRT" (HR = 2.118; p = 0.001) and "CKD with RRT" (HR = 3.043; p = 0.001) patients were associated with the primary endpoint of long-term mortality at 2 years, which was also proven after propensity-score matching (non-CKD vs. "CKD without RRT": 43% vs. 27%, log rank p = 0.001; HR = 1.847; "CKD without RRT" vs. "CKD with RRT": 74% vs. 51%, log rank p = 0.001; HR = 2.129). The rates of secondary endpoints were higher for cardiac death at 24 h, in-hospital death at index and the composite of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and cardiac death at 24 h, respectively, for "CKD without RRT" and "CKD with RRT" patients. CONCLUSION: In patients presenting with ventricular tachyarrhythmias and aborted SCA on admission, the presence of CKD, especially combined with RRT, is independently associated with an increase of long-term all-cause mortality at 2 years, cardiac death at 24 h, in-hospital death and the composite of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and cardiac death at 24 h.
BACKGROUND: The study sought to assess the prognostic impact of chronic kidney disease (CKD) and renal replacement therapy (RRT) in patients with ventricular tachyarrhythmias and sudden cardiac arrest (SCA) on admission. METHODS: A large retrospective registry was used including all consecutive patients presenting with ventricular tachycardia (VT), fibrillation (VF) and SCA on admission from 2002 to 2016. Non-CKD vs. "CKD without RRT", and "CKD without RRT" vs. "CKD with RRT" were compared applying multivariable Cox regression models and propensity-score matching for evaluation of the primary prognostic endpoint defined as long-term all-cause mortality at 2 years. Secondary prognostic endpoints were cardiac death at 24 h, in-hospital death at index and the composite endpoint of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and cardiac death at 24 h. RESULTS: In 2686 unmatched high-risk patients with ventricular tachyarrhythmias and SCA, non-CKD was present in 46%, "CKD without RRT" in 46% and "CKD with RRT" in 8%. Each, VT and VF occurred in about one-third of CKD patients. Multivariable Cox regression models revealed that "CKD without RRT" (HR = 2.118; p = 0.001) and "CKD with RRT" (HR = 3.043; p = 0.001) patients were associated with the primary endpoint of long-term mortality at 2 years, which was also proven after propensity-score matching (non-CKD vs. "CKD without RRT": 43% vs. 27%, log rank p = 0.001; HR = 1.847; "CKD without RRT" vs. "CKD with RRT": 74% vs. 51%, log rank p = 0.001; HR = 2.129). The rates of secondary endpoints were higher for cardiac death at 24 h, in-hospital death at index and the composite of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and cardiac death at 24 h, respectively, for "CKD without RRT" and "CKD with RRT" patients. CONCLUSION: In patients presenting with ventricular tachyarrhythmias and aborted SCA on admission, the presence of CKD, especially combined with RRT, is independently associated with an increase of long-term all-cause mortality at 2 years, cardiac death at 24 h, in-hospital death and the composite of recurrent ventricular tachyarrhythmias, appropriate ICD therapies and cardiac death at 24 h.
Authors: Kathrin Weidner; Michael Behnes; Tobias Schupp; Jorge Hoppner; Ibrahim El-Battrawy; Uzair Ansari; Ahmad Saleh; Gabriel Taton; Linda Reiser; Armin Bollow; Thomas Reichelt; Dominik Ellguth; Niko Engelke; Thomas Bertsch; Dirk Große Meininghaus; Ursula Hoffmann; Ibrahim Akin Journal: BMC Cardiovasc Disord Date: 2022-03-31 Impact factor: 2.298
Authors: Julian Müller; Michael Behnes; Tobias Schupp; Linda Reiser; Gabriel Taton; Thomas Reichelt; Dominik Ellguth; Martin Borggrefe; Niko Engelke; Armin Bollow; Seung-Hyun Kim; Kathrin Weidner; Uzair Ansari; Kambis Mashayekhi; Muharrem Akin; Philipp Halbfass; Dirk Große Meininghaus; Ibrahim Akin; Jonas Rusnak Journal: Heart Vessels Date: 2021-11-16 Impact factor: 2.037
Authors: Refik Kavsur; Marc Ulrich Becher; Welat Nassan; Alexander Sedaghat; Adem Aksoy; Jan Wilko Schrickel; Georg Nickenig; Vedat Tiyerili Journal: Int J Cardiol Heart Vasc Date: 2021-05-25