Universität zu Köln

Schueler, Robert, Nickenig, Georg, May, Andreas E., Schillinger, Wolfgang, Bekeredjian, Raffi, Ouarrak, Taoufik, Schofer, Joachim, Hehrlein, Christoph, Sievert, Horst, Boekstegers, Peter, Lubos, Edith, Hoffmann, Rainer, Baldus, Stephan, Senges, Jochen and Hammerstingl, Christoph (2016). Predictors for short-term outcomes of patients undergoing transcatheter mitral valve interventions: analysis of 778 prospective patients from the German TRAMI registry focusing on baseline renal function. EuroIntervention, 12 (4). S. 508 - 515. TOULOUSE CEDEX 6: EUROPA EDITION. ISSN 1969-6213

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Abstract

Aims: Factors predicting outcomes after MitraClip implantation are not well defined. We aimed to report the influence of baseline renal function on short-term outcomes of patients enrolled in the investigator-initiated German transcatheter mitral valve interventions (TRAMI) registry. Methods and results: Twenty participating German centres prospectively included 778 patients (mean age 76.0 years [71-81], 38.8% female gender) at high surgical risk (mean logistic EuroSCORE 20% [12-32%]) undergoing TMVR with the MitraClip for the treatment of symptomatic functional (70%) or degenerative (30%) mitral valve regurgitation (FMR, DMR). The patients were stratified according to renal function before clip implantation. The prevalence of moderate to severe renal impairment (glomerular filtration rate [GFR] < 60 ml/min) was 62.7% (37.3%, normal renal function [GFR > 60 ml/min]; 49.6%, moderate renal impairment [GFR 30-60 ml/min]; 13.1%, severe renal impairment [GFR < 30 ml/min]). TMVR was successfully completed in 98.2% of cases; acute procedural failure, in-hospital and 30-day mortality rates were 1.8%, 2.3% and 4.4%, respectively. Acute procedural failure and mortality rates (in-hospital, 30-day) were significantly higher in patients with severe renal impairment (5.9%, 7.8%, 14.1%), as compared to patients with moderately (1%, 1.3%, 3.0%) or mildly impaired to normal (1.4%, 1.7%, 2.9%) renal function (p < 0.0001). Following Cox regression analysis, the prevalence of severe renal impairment at the time of TMVR was the only predictor for increased 30-day mortality rates (hazard ratio 3.42, 95% confidence interval 1.88-6.2; p < 0.0001). Conclusions: Renal function at the time of interventional mitral valve repair with the MitraClip system is a strong predictor for procedural outcomes. Patients with severe renal impairment have a more than threefold increased risk for acute procedural failure, in-hospital death and 30-day mortality.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schueler, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Nickenig, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED May, Andreas E. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schillinger, Wolfgang UNSPECIFIED UNSPECIFIED UNSPECIFIED Bekeredjian, Raffi UNSPECIFIED UNSPECIFIED UNSPECIFIED Ouarrak, Taoufik UNSPECIFIED UNSPECIFIED UNSPECIFIED Schofer, Joachim UNSPECIFIED UNSPECIFIED UNSPECIFIED Hehrlein, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Sievert, Horst UNSPECIFIED UNSPECIFIED UNSPECIFIED Boekstegers, Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Lubos, Edith UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Senges, Jochen UNSPECIFIED UNSPECIFIED UNSPECIFIED Hammerstingl, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-271421
Journal or Publication Title:	EuroIntervention
Volume:	12
Number:	4
Page Range:	S. 508 - 515
Date:	2016
Publisher:	EUROPA EDITION
Place of Publication:	TOULOUSE CEDEX 6
ISSN:	1969-6213
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language HEART-FAILURE; DYSFUNCTION; SURGERY; REPAIR; RISK; REGURGITATION; METAANALYSIS; IMPAIRMENT; MORTALITY; SURVIVAL Multiple languages Cardiac & Cardiovascular Systems Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/27142