Author:
Weidner Kathrin,Behnes Michael,Schupp Tobias,Hoppner Jorge,Ansari Uzair,Mueller Julian,Lindner Simon,Borggrefe Martin,Kim Seung-hyun,Huseyinov Aydin,Ellguth Dominik,Akin Muharrem,Meininghaus Dirk Große,Bertsch Thomas,Taton Gabriel,Bollow Armin,Reichelt Thomas,Engelke Niko,Reiser Linda,Akin Ibrahim
Abstract
Abstract
Background
The study sought to assess the prognostic impact of chronic kidney disease (CKD) in patients with electrical storm (ES). ES represents a life-threatening heart rhythm disorder. In particular, CKD patients are at risk of suffering from ES. However, data regarding the prognostic impact of CKD on long-term mortality in ES patients is limited.
Methods
All consecutive ES patients with an implantable cardioverter–defibrillator (ICD) were included retrospectively from 2002 to 2016. Patients with CKD (MDRD-GFR < 60 ml/min/1.73 m2) were compared to patients without CKD. The primary endpoint was all-cause mortality at 3 years. Secondary endpoints were in-hospital mortality, cardiac rehospitalization, recurrences of electrical storm (ES-R), and major adverse cardiac events (MACE) at 3 years.
Results
A total of 70 consecutive ES patients were included. CKD was present in 43% of ES patients with a median glomerular filtration rate (GFR) of 43.3 ml/min/1.73 m2. CKD was associated with increased all-cause mortality at 3 years (63% vs. 20%; p = 0.001; HR = 4.293; 95% CI 1.874–9.836; p = 0.001) and MACE (57% vs. 30%; p = 0.025; HR = 3.597; 95% CI 1.679–7.708; p = 0.001). In contrast, first cardiac rehospitalization (43% vs. 45%; log-rank p = 0.889) and ES-R (30% vs. 20%; log-rank p = 0.334) were not affected by CKD. Even after multivariable adjustment, CKD was still associated with increased long-term mortality (HR = 2.397; 95% CI 1.012–5.697; p = 0.047), as well as with the secondary endpoint MACE (HR = 2.520; 95% CI 1.109–5.727; p = 0.027).
Conclusions
In patients with ES, the presence of CKD was associated with increased long-term mortality and MACE.
Publisher
Springer Science and Business Media LLC
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine