JACC:经导管主动脉瓣置换术后的透析:危险因素和结局

2017-10-21 xiangting MedSci原创

TAVR后需要透析的患者比例随时间而下降。

这项研究旨在确定经导管主动脉瓣置换(TAVR)术后透析的危险因素,并确定TAVR前或TAVR后透析对死亡率的影响。

TAVR现在被确定为手术主动脉瓣置换术的替代治疗。目前缺乏透析对TAVR后结局影响的数据。

英国TAVI(经导管主动脉瓣植入)登记旨在记录英国(2007年至2014年)进行的所有TAVR手术的结局。前瞻性收集6464例患者的资料,并中位随访625天。

TAVR前进行透析的患者比例保持在1.8%。TAVR后新进透析患者的比例从6.1%(2007-2008年)降至2.3%(2013-2014年)。TAVR后透析的风险与基线肾功能差、手术年限、左室功能受损、糖尿病、爱德华兹瓣膜使用、非经股动脉通路、需要开腹手术以及中重度手术后主动脉返流相关。与不需要透析的患者相比,TAVR后需要透析与30天(风险比:6.44; 95%置信区间:4.87至8.53)和4年(风险比:3.54; 95%置信区间:2.99至4.19; p<0.001)的死亡率较高相关。

TAVR后需要透析的患者比例随时间而下降。TAVR后透析与死亡率升高相关。用于识别TAVR后需要透析的因素尚需进一步调查。

原始出处:
Charles J. Ferro, Jonathan P. Law, Sagar N. Doshi, et al. Dialysis Following Transcatheter Aortic Valve Replacement: Risk Factors and Outcomes. JACC: Cardiovascular Interventions. October 2017. 

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    2017-11-06 hbwxf
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    2018-07-20 yxch48
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encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367099, encodeId=7faa136e0996a, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415207, encodeId=4e14141520ebd, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510093, encodeId=164c151009327, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536511, encodeId=241d15365116c, content=<a href='/topic/show?id=a894e826546' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78265, encryptionId=a894e826546, topicName=经导管主动脉瓣置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38112697961, createdName=yytms, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576576, encodeId=5f8815e65768e, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254927, encodeId=de6925492ed5, content=谢谢分享.很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6831717982, createdName=微分, createdTime=Sat Oct 21 21:18:33 CST 2017, time=2017-10-21, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1853816, encodeId=f0ee18538161b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Nov 06 18:24:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742433, encodeId=8e7b1e424335b, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jul 20 23:24:00 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325569, encodeId=d7141325569f6, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332458, encodeId=0f9e13324587b, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367099, encodeId=7faa136e0996a, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415207, encodeId=4e14141520ebd, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510093, encodeId=164c151009327, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536511, encodeId=241d15365116c, content=<a href='/topic/show?id=a894e826546' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78265, encryptionId=a894e826546, topicName=经导管主动脉瓣置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38112697961, createdName=yytms, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576576, encodeId=5f8815e65768e, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254927, encodeId=de6925492ed5, content=谢谢分享.很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6831717982, createdName=微分, createdTime=Sat Oct 21 21:18:33 CST 2017, time=2017-10-21, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1853816, encodeId=f0ee18538161b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Nov 06 18:24:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742433, encodeId=8e7b1e424335b, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, createdName=yxch48, createdTime=Fri Jul 20 23:24:00 CST 2018, time=2018-07-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325569, encodeId=d7141325569f6, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1332458, encodeId=0f9e13324587b, content=<a href='/topic/show?id=1dd6231822d' target=_blank style='color:#2F92EE;'>#主动脉瓣#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23182, encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367099, encodeId=7faa136e0996a, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415207, encodeId=4e14141520ebd, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510093, encodeId=164c151009327, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536511, encodeId=241d15365116c, content=<a href='/topic/show?id=a894e826546' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78265, encryptionId=a894e826546, topicName=经导管主动脉瓣置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38112697961, createdName=yytms, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576576, encodeId=5f8815e65768e, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254927, encodeId=de6925492ed5, content=谢谢分享.很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6831717982, createdName=微分, createdTime=Sat Oct 21 21:18:33 CST 2017, time=2017-10-21, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1853816, encodeId=f0ee18538161b, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Mon Nov 06 18:24:00 CST 2017, time=2017-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742433, encodeId=8e7b1e424335b, content=<a href='/topic/show?id=39cae96626f' target=_blank style='color:#2F92EE;'>#置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79662, encryptionId=39cae96626f, topicName=置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=3a7c35056336, 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encryptionId=1dd6231822d, topicName=主动脉瓣)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=dc4b2500077, createdName=hittouch, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1367099, encodeId=7faa136e0996a, content=<a href='/topic/show?id=b6222320322' target=_blank style='color:#2F92EE;'>#主动脉瓣置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23203, encryptionId=b6222320322, topicName=主动脉瓣置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b24249, createdName=medsci246, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415207, encodeId=4e14141520ebd, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1510093, encodeId=164c151009327, content=<a href='/topic/show?id=e9bce8254ef' target=_blank style='color:#2F92EE;'>#经导管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78254, encryptionId=e9bce8254ef, topicName=经导管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1536511, encodeId=241d15365116c, content=<a href='/topic/show?id=a894e826546' target=_blank style='color:#2F92EE;'>#经导管主动脉瓣置换#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78265, encryptionId=a894e826546, topicName=经导管主动脉瓣置换)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b38112697961, createdName=yytms, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1576576, encodeId=5f8815e65768e, content=<a href='/topic/show?id=48fee966468' target=_blank style='color:#2F92EE;'>#置换术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79664, encryptionId=48fee966468, topicName=置换术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=778d36, createdName=柳叶一刀, createdTime=Mon Oct 23 06:24:00 CST 2017, time=2017-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254927, encodeId=de6925492ed5, content=谢谢分享.很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6831717982, createdName=微分, createdTime=Sat Oct 21 21:18:33 CST 2017, time=2017-10-21, status=1, ipAttribution=)]
  8. 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  9. 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=254927, encodeId=de6925492ed5, content=谢谢分享.很好, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a6831717982, createdName=微分, createdTime=Sat Oct 21 21:18:33 CST 2017, time=2017-10-21, status=1, ipAttribution=)]
    2017-10-21 微分

    谢谢分享.很好

    0

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