Transkateter Aortik Kapak Replasmanında Kısa Süreli Takipte Cinsiyet Farkı

2020 ◽  
Vol 1 (3) ◽  
pp. 79-84
Author(s):  
Örsan Deniz Urgun ◽  
Gülüzar Traş ◽  
İbrahim Halil Kurt ◽  
Salih Kılıç
Keyword(s):  
Sex Difference ◽  
Prognostic Value ◽  
Primary Outcome ◽  
Female Gender ◽  
Record System ◽  
Transcatheter Aortic Valve ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Study Population

Introduction: The prognostic value sex difference demonstrated in cardiovascular diseases. In present study, we evaluated the prognostic value of sex difference in patients who underwent transcatheter aortic valve replacement (TAVI). Material and Methods: Totally, 130 patients who underwent TAVI between January 2016 and December 2018 included retrospectively. Median follow-up time was 324 (IQR 226) days. Demographic characteristic of patients recorded from hospital record system and patients’ fields. Primary outcome was all cause mortality during follow-up.  Results: Mean age of study population was 77.1 ± 7.8 years and female gender was significantly older than male gender. There was no significant difference between groups in term of demographic and laboratory parameters except smoker rate and mean haemoglobin level. During follow-up totally 34 (%26.2) patients were died (male 34.5%, female 20.0%; p= 0.062) and there was no significant difference between groups. Conclusion: In our single-center retrospective study, we showed that there was no significant difference in gender difference in all-cause mortality during short-term follow-up after TAVI.

scholarly journals Left atrial functional assessment and mortality in patients with severe aortic stenosis with sinus rhythm

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
João Ferreira ◽  
Valdirene Gonçalves ◽  
Patrícia Marques-Alves ◽  
Rui Martins ◽  
Sílvia Monteiro ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Left Atrial ◽  
Primary Outcome ◽  
Severe Aortic Stenosis ◽  
Heart Team ◽  
Pump Function ◽  
Volumetric Assessment ◽  
All Cause Mortality ◽  
Echocardiography Laboratory

Abstract Background Aortic valve stenosis (AS) is the most common primary valvular heart disease leading to surgical or percutaneous aortic valve replacement (AVR) in Europe and its prevalence keeps growing. While other risk factors in severe AS are well documented, little is known about the prognostic value of left atrial (LA) function in AS. Our aim is to clarify the relationship between LA function measured at severe AS diagnosis (evaluated by means of volumetric assessment) and all-cause mortality during follow-up. Methods We retrospectively evaluated patients diagnosed with severe AS for the first time at our echocardiography laboratory. We evaluated LA reservoir, conduit and pump function by measuring LA volumes at different timings of cardiac cycle. Treatment strategy was decided according to heart team consensus and patient decision. We divided patients into groups according to terciles of LA reservoir, conduit and pump function. Primary outcome was defined by the occurrence of all-cause mortality during follow-up. Results A total of 408 patients were included in the analysis, with a median follow-up time of 45 months (interquartile range 54 months). 57.9% of patients underwent AVR and 44.9% of patients registered the primary outcome during follow-up. Left atrial emptying fraction (LAEF) was the best LA functional parameter and the best overall parameter in discriminating primary outcome (AUC 0.845, 95%CI 0.81–0.88, P < 0.001). After adjustment for clinical, demographic and echocardiographic variables, cumulative survival of patients with LAEF < 37% and LAEF 37 to 53% relative to patients with LAEF ≥54% remained significantly lower (HR 13.91, 95%CI 6.20–31.19, P < 0.001 and HR 3.40, 95%CI 1.57–7.37, P = 0.002, respectively). After adjustment for AVR, excess risk of LAEF < 37% and LAEF 37 to 53% relative to LAEF ≥54% remained significant (HR 11.71, 95%CI 5.20–26.40, P < 0.001 and HR 3.59, 95%CI 1.65–7.78, P = 0.001, respectively). Conclusions In patients with a first diagnosis of severe AS, LA function, evaluated by means of volumetric assessment, is an independent predictor of all-cause mortality and a more potent predictor of death compared to classical severity parameters. These data can be useful to identify high-risk patients who might benefit of AVR.

scholarly journals Intracameral Bevacizumab Versus Sub-Tenon’s Mitomycin C as Adjuncts to Trabeculectomy: 3-Year Results of a Prospective Randomized Study

2021 ◽  
Vol 10 (10) ◽  
pp. 2054
Author(s):  
Gerasimos Kopsinis ◽  
Dimitrios Tsoukanas ◽  
Dimitra Kopsini ◽  
Theodoros Filippopoulos
Keyword(s):  
Mitomycin C ◽  
Primary Outcome ◽  
Randomized Study ◽  
Primary Outcome Measure ◽  
Complication Rates ◽  
Filtration Surgery ◽  
Significant Difference ◽  
Exfoliative Glaucoma

Conjunctival wound healing determines success after filtration surgery and the quest for better antifibrotic agents remains active. This study compares intracameral bevacizumab to sub-Tenon’s mitomycin C (MMC) in trabeculectomy. Primary open-angle or exfoliative glaucoma patients were randomized to either bevacizumab (n = 50 eyes) or MMC (n = 50 eyes). The primary outcome measure was complete success, defined as Intraocular Pressure (IOP) > 5 mmHg and ≤ 21 mmHg with a minimum 20% reduction from baseline without medications. Average IOP and glaucoma medications decreased significantly in both groups at all follow-up points compared to baseline (p < 0.001), without significant difference between groups at 3 years (IOP: bevacizumab group from 29 ± 9.4 to 15 ± 3.4 mmHg, MMC group from 28.3 ± 8.7 to 15.4 ± 3.8 mmHg, p = 0.60; Medications: bevacizumab group from 3.5 ± 0.9 to 0.5 ± 1, MMC group from 3.6 ± 0.7 to 0.6 ± 1.1, p = 0.70). Complete success, although similar between groups at 3 years (66% vs. 64%), was significantly higher for bevacizumab at months 6 and 12 (96% vs. 82%, p = 0.03; 88% vs. 72%, p = 0.04, respectively) with fewer patients requiring medications at months 6, 9 and 12 (4% vs. 18%, p = 0.03; 6% vs. 20%, p = 0.04; 8% vs. 24%, p = 0.03, respectively). Complication rates were similar between groups. In conclusion, intracameral bevacizumab appears to provide similar long-term efficacy and safety results as sub-Tenon’s MMC after trabeculectomy.

The Relationship between Serum Ferritin Levels and 5-Year All-Cause Mortality in Hemodialysis Patients

2021 ◽  
pp. 1-7
Author(s):  
Emre Erdem ◽  
Ahmet Karatas ◽  
Tevfik Ecder
Keyword(s):  
Serum Ferritin ◽  
Hemodialysis Patients ◽  
Rank Test ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Group 3 ◽  
Group 2 ◽  
The Relationship ◽  
Group 1

<b><i>Introduction:</i></b> The effect of high serum ferritin levels on long-term mortality in hemodialysis patients is unknown. The relationship between serum ferritin levels and 5-year all-cause mortality in hemodialysis patients was investigated in this study. <b><i>Methods:</i></b> A total of 173 prevalent hemodialysis patients were included in this study. The patients were followed for up to 5 years and divided into 3 groups according to time-averaged serum ferritin levels (group 1: serum ferritin &#x3c;800 ng/mL, group 2: serum ferritin 800–1,500 ng/mL, and group 3: serum ferritin &#x3e;1,500 ng/mL). Along with the serum ferritin levels, other clinical and laboratory variables that may affect mortality were also included in the Cox proportional-hazards regression analysis. <b><i>Results:</i></b> Eighty-one (47%) patients died during the 5-year follow-up period. The median follow-up time was 38 (17.5–60) months. The 5-year survival rates of groups 1, 2, and 3 were 44, 64, and 27%, respectively. In group 3, the survival was lower than in groups 1 and 2 (log-rank test, <i>p</i> = 0.002). In group 1, the mortality was significantly lower than in group 3 (HR [95% CI]: 0.16 [0.05–0.49]; <i>p</i> = 0.001). In group 2, the mortality was also lower than in group 3 (HR [95% CI]: 0.32 [0.12–0.88]; <i>p</i> = 0.026). No significant difference in mortality between groups 1 and 2 was found (HR [95% CI]: 0.49 [0.23–1.04]; <i>p</i> = 0.063). <b><i>Conclusion:</i></b> Time-averaged serum ferritin levels &#x3e;1,500 ng/mL in hemodialysis patients are associated with an increased 5-year all-cause mortality risk.

Canadian Registry of Electronic Device Outcomes: remote monitoring outcomes in the Abbott battery performance alert—a multicentre cohort

EP Europace ◽  
2021 ◽  
Author(s):  
Sharath Kumar ◽  
Jason Davis ◽  
Bernard Thibault ◽  
Iqwal Mangat ◽  
Benoit Coutu ◽  
...  
Keyword(s):  
Remote Monitoring ◽  
Primary Outcome ◽  
Electronic Device ◽  
Electronic Devices ◽  
Cardiac Resynchronization ◽  
Device Performance ◽  
Cardiac Implantable Electronic Devices ◽  
All Cause Mortality ◽  
Multicentre Cohort

Abstract Aims Cardiac implantable electronic devices with device advisories have the potential of device malfunction. Remote monitoring (RM) of devices has been suggested to allow the identification of abnormal device performance and permit early intervention. We sought to describe the outcomes of patients with and without RM in devices subject to the Abbott Premature Battery Depletion (PBD) advisory with data from a Canadian registry. Methods and results Patients with an Abbott device subject to the PBD advisory from nine implantable cardioverter defibrillator (ICD) implanting centres in Canada were included in the registry. The use of RM was identified from baseline and follow-up data in the registry. The primary outcome was detection of PBD and all-cause mortality. A total of 2666 patients were identified with a device subject to the advisory. In all, 1687 patients (63.2%) had RM at baseline. There were 487 deaths during follow-up. At a mean follow-up of 5.7 ± 0.7 years, mortality was higher in those without a remote monitor compared with RM at baseline (24.7% vs. 14.5%; P &lt; 0.001). Pre-mature battery depletion was identified in 36 patients (2.1%) with RM vs. 7 (0.7%) without RM (P = 0.004). Time to battery replacement was significantly reduced in patients on RM (median 5 vs. 13 days, P = 0.001). Conclusion The use of RM in patients with ICD and cardiac resynchronization therapy under advisory improved detection of PBD, time to device replacement, and was associated with a reduction in all-cause mortality. The factors influencing the association with mortality are unknown and deserve further study.

Late Health Effects of Radiation for Eustachian Tube Dysfunction: Previous Results and Ongoing Study in the Netherlands

1996 ◽  
Vol 115 (5) ◽  
pp. 417-421
Author(s):  
Peter G. Verduijn
Keyword(s):  
The Netherlands ◽  
Health Effects ◽  
Urogenital System ◽  
Neck Tumors ◽  
Significant Difference ◽  
Tube Dysfunction ◽  
Study Population ◽  
Effects Of Radiation ◽  
Nose And Throat

To study the late health effects of nasopharyngeal radium irradiation, a nonconcurrent prospective study was conducted in The Netherlands. Exposed subjects ( n = 2510) were treated unilaterally with nasopharyngeal radium irradiation at five ear, nose, and throat clinics between 1945 and 1965 and followed up through February 1, 1985. Unexposed subjects ( n = 2199) were matched to treated patients according to clinic, year of birth, and first consultation within 5 years. No overall significant increase in cancer mortality was found. A statistically significant difference was noted only for cumulative all-site cancer incidence, with the exposed having twice as many verified cancers as the nonexposed. This excess risk was caused mainly by head and neck tumors and other tumors flung, digestive tract, and urogenital system). The relative risk for these specific sites, however, was not significantly different from 1.00. These findings corroborate the hypothesis that there is some risk of tumor induction involved with nasopharyngeal radium irradiation at the dose level applied to this population. Because of ongoing interest in this subject, I plan to extend the follow-up of the cohort through December 31, 1995, and I am studying the possibility of expanding the study population.

scholarly journals Association of Body Weight Variability with Adverse Cardiovascular Outcomes in Patients with Pre-Dialysis Chronic Kidney Disease

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3381
Author(s):  
Sang Heon Suh ◽  
Tae Ryom Oh ◽  
Hong Sang Choi ◽  
Chang Seong Kim ◽  
Eun Hui Bae ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Body Weight ◽  
Kidney Disease ◽  
Primary Outcome ◽  
Body Weight Gain ◽  
Absolute Difference ◽  
Composite Outcome ◽  
Increased Risk ◽  
All Cause Mortality

To investigate the association of body weight variability (BWV) with adverse cardiovascular (CV) outcomes in patient with pre-dialysis chronic kidney disease (CKD), a total of 1867 participants with pre-dialysis CKD from Korean Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD) were analyzed. BWV was defined as the average absolute difference between successive values. The primary outcome was a composite of non-fatal CV events and all-cause mortality. Secondary outcomes were fatal and non-fatal CV events and all-cause mortality. High BWV was associated with increased risk of the composite outcome (adjusted hazard ratio (HR) 1.745, 95% confidence interval (CI) 1.065 to 2.847) as well as fatal and non-fatal CV events (adjusted HR 1.845, 95% CI 1.136 to 2.996) and all-cause mortality (adjusted HR 1.861, 95% CI 1.101 to 3.145). High BWV was associated with increased risk of fatal and non-fatal CV events, even in subjects without significant body weight gain or loss during follow-up periods (adjusted HR 2.755, 95% CI 1.114 to 6.813). In conclusion, high BWV is associated with adverse CV outcomes in patients with pre-dialysis CKD.

scholarly journals Electrical Substrate Ablation for Refractory Ventricular Fibrillation: Results of the AVATAR Study

2021 ◽  
Author(s):  
David E. Krummen ◽  
Gordon Ho ◽  
Kurt S. Hoffmayer ◽  
Franz Schweis ◽  
Tina Baykaner ◽  
...  
Keyword(s):  
Ventricular Fibrillation ◽  
Primary Outcome ◽  
Reference Group ◽  
Group Versus ◽  
Electrical Storm ◽  
Antiarrhythmic Drug Therapy ◽  
All Cause Mortality ◽  
Rapid Pacing ◽  
Optimal Treatment Strategy

Background - Refractory ventricular fibrillation (VF) is a challenging clinical entity, for which ablation of triggering premature ventricular complexes (PVCs) is described. When PVCs are infrequent and multifocal, the optimal treatment strategy is uncertain. Methods - We prospectively enrolled consecutive patients presenting with multiple ICD shocks for VF refractory to antiarrhythmic drug therapy, exhibiting infrequent (≤3%), multifocal PVCs (≥3 morphologies). Procedurally, VF was induced with rapid pacing and mapped, identifying sites of conduction slowing and rotation or rapid focal activation. VF electrical substrate ablation (VESA) was then performed. Outcomes were compared against reference patients with VF who were unable or unwilling to undergo catheter ablation. The primary outcome was a composite of ICD shock, electrical storm, or all-cause mortality. Results - VF was induced and mapped in 6 patients (60±10 y, LVEF 46±19%) with ischemic (n=3) and nonischemic cardiomyopathy. An average of 3.3±0.5 sites of localized reentry during VF were targeted for radiofrequency ablation (38.3±10.9 minutes) during sinus rhythm, rendering VF non-inducible with pacing. Freedom from the primary outcome was 83% in the VF ablation group versus 17% in 6 non-ablation reference patients at a median of 1.0 years (IQR 0.5-1.5 years, p=0.046) follow-up. Conclusions - VESA is associated with a reduction in the combined endpoint compared with the non-ablation reference group. Additional work is required to understand the precise pathophysiologic changes which promote VF in order to improve preventative and therapeutic strategies.

Abstract TP150: Effects of Pre-existing Psychotropic Medication Use on a Cohort of Patients With Ischemic Stroke Outcome

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Dilip Jayaraman ◽  
Nils Henninger ◽  
Brian Silver ◽  
Majaz Moonis ◽  
Anthony Rothschild ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Psychotropic Medication ◽  
Medication Use ◽  
Female Gender ◽  
Control Group ◽  
Stroke Outcome ◽  
Stroke Registry ◽  
Post Stroke ◽  
Significant Difference

Background: Although SSRI use for ischemic stroke related motor recovery has been studied with mixed results, the effects of the pre-existing psychotropic medication use (PPMU), such as antidepressants, on a long-term ischemic stroke outcome is unknown. Objective: We sought to determine the prevalence of PPMU, and the clinical outcome in a cohort of patients presenting with acute ischemic strokes. Methods: We retrospectively analyzed 323 consecutive patients who presented with an acute ischemic stroke that were included in an institutional stroke registry between January 2015 and December 2017. Baseline characteristics, functional outcome measured by mRS, cardiovascular complications and death within 90 days and 365 days were recorded. The control was defined as a group of ischemic stroke patients that were not on psychotropic medications pre- and/or post-ischemic stroke. Results: The prevalence of PPMU in the studied cohort was 21.4% (69/323). The prevalence of female gender in PPMU was higher compared to the control and post stroke-psychotropic medication use groups (P<0.001), and the patients with PPMU had similar vascular risk factors compared to the control (NS), except for an increased presence of hyperlipidemia (68.1% vs. 57.5%, p<0.05). Among the patients with an available 90-day follow-up (n=175) and 365-day follow-up (n=246), there was no statistically significant difference in outcome events of MI, stroke, death, and dementia. The mRS was higher on PPMU and poststroke-psychotropic medication use groups compared to the control group within the 365-day follow-up (P=0.013). Conclusion: The prevalence of PPMU is common in ischemic stroke, and it is not associated with worsened post-stroke complications within 1 year.

Abstract 15741: Long Term Survival Following Transcatheter Aortic Valve Replacement: Results From a Single US High Volume Center

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ricardo O Escarcega ◽  
Rebecca Torguson ◽  
Marco A Magalhaes ◽  
Nevin C Baker ◽  
Sa’ar Minha ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Aortic Valve Replacement ◽  
Valve Replacement ◽  
Transcatheter Aortic Valve Replacement ◽  
Term Survival ◽  
Transcatheter Aortic Valve ◽  
Significant Difference ◽  
Long Term Mortality

Introduction: Mortality following Transcatheter aortic valve replacement (TAVR) has been reported up to 5 years. However, mortality after 5 years remains unclear. Hypothesis: We aim to determine the mortality in patients undergoing TAVR >5 years follow up. Methods: From our institution’s prospectively collected TAVR database we analyzed all patients undergoing TAVR to a maximum follow up of 8 years. We divided our population into transapical TAVR (TA-TAVR) and transfemoral TAVR (TF-TAVR) groups. A Kaplan-Meier survival analysis was conducted. Results: A total of 511 patients who underwent TAVR were included in the analysis. Patients undergoing TA-TAVR had higher rates of peripheral vascular disease compared with TF-TAVR (56% vs 29%, p<0.001) and Society of Thoracic Surgeons Score (10.9 ± 4 vs 9.2 ± 4, p<0.001). TA-TAVR was associated with higher mortality at 1 year (32% vs 21%, p=0.01). However, there was no significant difference in very-long term mortality of patients undergoing TA-TAVR vs TF-TAVR (Figure). Conclusions: Long-term mortality following TAVR surpasses 50%. While in the first 2 years TA-TAVR is associated with higher mortality rates after three years the survival rates are similar in both approaches.

P2878Higher all-cause mortality in patients with implanted dual-chamber cardioverter-defibrillators for secondary prevention: an analysis from the Polish ICD Registry

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
I Warchol ◽  
A Lubinski ◽  
M Sterlinski ◽  
O Kowalski ◽  
K Goscinska-Bis ◽  
...  
Keyword(s):  
Secondary Prevention ◽  
Implantable Cardioverter Defibrillators ◽  
Dual Chamber ◽  
Single Chamber ◽  
Kaplan Meier ◽  
Significant Difference ◽  
All Cause Mortality ◽  
National Cohort ◽  
Cardioverter Defibrillators

Abstract Background In the Polish ICD Registry population secondary prevention recipients account for over 27%. Despite the evolution of indications for secondary prevention implantable cardioverter defibrillators (ICDs), recommendations regarding the use of ICDs for secondary prevention of sudden cardiac death (SCD) rely on information from a small number of randomized controlled trials that were performed decades ago, with mixed results. Moreover, research on the outcomes after implantations for secondary prevention of ICDs is limited. While dual-chamber devices offer theoretical advantage over single-chamber devices, dual-chamber ICDs (DC-ICDs) were announced not superior to single-chamber (SC-ICDs) in some research. Purpose Therefore, the aim of the study was to evaluate the all-cause mortality among patients from the Polish ICD Registry receiving either a single- or a dual-chamber device for secondary prevention in contemporary clinical practice. Methods All patients enrolled in the Polish ICD Registry from 1995 to 2016 were identified. Patients were included in the study if they were designated as receiving an ICD for secondary prevention of SCD after documented tachycardic arrest, sustained ventricular tachycardia (VT), or syncope. Kaplan-Meier survival analysis was used to assess all-cause mortality. Results In the study population of 3596 ICD recipients (mean age 69±12 years, 81% male, SC-ICD 61%, DC-ICD 39%), during mean follow-up of 79±43 months all-cause mortality rate was higher in the dual-chamber group than in the single chamber group, with a significant difference between the two groups as depicted in Kaplan-Meier curve (p<0,05). The median survival time was 98 months versus 110 months for SC and DC-ICD, respectively. Conclusions This study is the first to describe the characteristics of a national cohort of patients receiving a secondary prevention ICD in such a long follow-up period in contemporary practice. Implantation of a dual-chamber ICD was associated with higher all-cause mortality compared with single chamber devices.

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