Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure

David Zweiker; Lukas Fiedler; Gabor G Toth; Andreas Strouhal; Georg Delle-Karth; Guenter Stix; Harald Gabriel; Ronald K Binder; Martin Rammer; Michael Pfeffer; Paul Vock; Brigitte Lileg; Clemens Steinwender; Kurt Sihorsch; Florian Hintringer; Silvana Mueller; Fabian Barbieri; Martin Martinek; Wolfgang Tkalec; Nicolas Verheyen; Klemens Ablasser; Andreas Zirlik; Daniel Scherr

doi:10.3390/jcm11216548

Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure

David Zweiker, Lukas Fiedler, Gabor G Toth, Andreas Strouhal, Georg Delle-Karth, Guenter Stix, Harald Gabriel, Ronald K Binder, Martin Rammer, Michael Pfeffer, Paul Vock, Brigitte Lileg, Clemens Steinwender, Kurt Sihorsch, Florian Hintringer, Silvana Mueller, Fabian Barbieri, Martin Martinek, Wolfgang Tkalec, Nicolas VerheyenKlemens Ablasser, Andreas Zirlik, Daniel Scherr

Klinische Abteilung für Innere Medizin III (UK St. Pölten)

Publikation: Beitrag in Fachzeitschrift (peer-reviewed) › Artikel in Fachzeitschrift

1 Zitat (Scopus)

Abstract

BACKGROUND: As a preventive procedure, minimizing periprocedural risk is crucially important during left atrial appendage closure (LAAC).

METHODS: We included consecutive patients receiving LAAC at nine centres and assessed the relationship between baseline characteristics and the acute procedural outcome. Major procedural complications were defined as all complications requiring immediate invasive intervention or causing irreversible damage. Logistic regression was performed and included age and left-ventricular function. Furthermore, the association between acute complications and long-term outcomes was evaluated.

RESULTS: A total of 405 consecutive patients with a median age of 75 years (37% female) were included. 47% had a history of stroke. Median CHA2DS2-VASc score was 4 (interquartile range, 3-5) and the median HAS-BLED score was 3 (2-4). Major procedural complications occurred in 7% of cases. Low haemoglobin (OR 0.8, 95% CI 0.65-0.99 per g/dL, p = 0.040) and end-stage kidney disease (OR 13.0, CI 2.5-68.5, p = 0.002) remained significant in multivariate analysis. Anaemia (haemoglobin < 12 and < 13 g/dL in female and male patients) increased the risk of complications 2.2-fold.

CONCLUSIONS: The major complication rate was low in this high-risk patient population undergoing LAAC. End-stage kidney disease and low baseline haemoglobin were independently associated with a higher major complication rate.

Originalsprache	Englisch
Aufsatznummer	6548
Fachzeitschrift	Journal of Clinical Medicine
Jahrgang	11
Ausgabenummer	21
DOIs	https://doi.org/10.3390/jcm11216548
Publikationsstatus	Veröffentlicht - 04 Nov. 2022

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Allgemeine Medizin

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10.3390/jcm11216548

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Zweiker, D., Fiedler, L., Toth, G. G., Strouhal, A., Delle-Karth, G., Stix, G., Gabriel, H., Binder, R. K., Rammer, M., Pfeffer, M., Vock, P., Lileg, B., Steinwender, C., Sihorsch, K., Hintringer, F., Mueller, S., Barbieri, F., Martinek, M., Tkalec, W., ... Scherr, D. (2022). Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure. Journal of Clinical Medicine, 11(21), Artikel 6548. https://doi.org/10.3390/jcm11216548

@article{4dd668463ee94292a5abbbe86e8430dd,

title = "Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure",

abstract = "BACKGROUND: As a preventive procedure, minimizing periprocedural risk is crucially important during left atrial appendage closure (LAAC).METHODS: We included consecutive patients receiving LAAC at nine centres and assessed the relationship between baseline characteristics and the acute procedural outcome. Major procedural complications were defined as all complications requiring immediate invasive intervention or causing irreversible damage. Logistic regression was performed and included age and left-ventricular function. Furthermore, the association between acute complications and long-term outcomes was evaluated.RESULTS: A total of 405 consecutive patients with a median age of 75 years (37% female) were included. 47% had a history of stroke. Median CHA2DS2-VASc score was 4 (interquartile range, 3-5) and the median HAS-BLED score was 3 (2-4). Major procedural complications occurred in 7% of cases. Low haemoglobin (OR 0.8, 95% CI 0.65-0.99 per g/dL, p = 0.040) and end-stage kidney disease (OR 13.0, CI 2.5-68.5, p = 0.002) remained significant in multivariate analysis. Anaemia (haemoglobin < 12 and < 13 g/dL in female and male patients) increased the risk of complications 2.2-fold.CONCLUSIONS: The major complication rate was low in this high-risk patient population undergoing LAAC. End-stage kidney disease and low baseline haemoglobin were independently associated with a higher major complication rate.",

keywords = "atrial fibrillation, complications, dialysis, haemoglobin, left atrial appendage closure",

author = "David Zweiker and Lukas Fiedler and Toth, {Gabor G} and Andreas Strouhal and Georg Delle-Karth and Guenter Stix and Harald Gabriel and Binder, {Ronald K} and Martin Rammer and Michael Pfeffer and Paul Vock and Brigitte Lileg and Clemens Steinwender and Kurt Sihorsch and Florian Hintringer and Silvana Mueller and Fabian Barbieri and Martin Martinek and Wolfgang Tkalec and Nicolas Verheyen and Klemens Ablasser and Andreas Zirlik and Daniel Scherr",

note = "Funding Information: The Austrian Left Atrial Appendage Closure Registry received funding in the form of an unrestricted grant from Boston Scientific. This work received no specific funding. Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = nov,

day = "4",

doi = "10.3390/jcm11216548",

language = "English",

volume = "11",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "MDPI AG",

number = "21",

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Zweiker, D, Fiedler, L, Toth, GG, Strouhal, A, Delle-Karth, G, Stix, G, Gabriel, H, Binder, RK, Rammer, M, Pfeffer, M, Vock, P , Lileg, B, Steinwender, C, Sihorsch, K, Hintringer, F, Mueller, S, Barbieri, F, Martinek, M, Tkalec, W, Verheyen, N, Ablasser, K, Zirlik, A & Scherr, D 2022, 'Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure', Journal of Clinical Medicine, Jg. 11, Nr. 21, 6548. https://doi.org/10.3390/jcm11216548

TY - JOUR

T1 - Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure

AU - Zweiker, David

AU - Fiedler, Lukas

AU - Toth, Gabor G

AU - Strouhal, Andreas

AU - Delle-Karth, Georg

AU - Stix, Guenter

AU - Gabriel, Harald

AU - Binder, Ronald K

AU - Rammer, Martin

AU - Pfeffer, Michael

AU - Vock, Paul

AU - Lileg, Brigitte

AU - Steinwender, Clemens

AU - Sihorsch, Kurt

AU - Hintringer, Florian

AU - Mueller, Silvana

AU - Barbieri, Fabian

AU - Martinek, Martin

AU - Tkalec, Wolfgang

AU - Verheyen, Nicolas

AU - Ablasser, Klemens

AU - Zirlik, Andreas

AU - Scherr, Daniel

N1 - Funding Information: The Austrian Left Atrial Appendage Closure Registry received funding in the form of an unrestricted grant from Boston Scientific. This work received no specific funding. Publisher Copyright: © 2022 by the authors.

PY - 2022/11/4

Y1 - 2022/11/4

N2 - BACKGROUND: As a preventive procedure, minimizing periprocedural risk is crucially important during left atrial appendage closure (LAAC).METHODS: We included consecutive patients receiving LAAC at nine centres and assessed the relationship between baseline characteristics and the acute procedural outcome. Major procedural complications were defined as all complications requiring immediate invasive intervention or causing irreversible damage. Logistic regression was performed and included age and left-ventricular function. Furthermore, the association between acute complications and long-term outcomes was evaluated.RESULTS: A total of 405 consecutive patients with a median age of 75 years (37% female) were included. 47% had a history of stroke. Median CHA2DS2-VASc score was 4 (interquartile range, 3-5) and the median HAS-BLED score was 3 (2-4). Major procedural complications occurred in 7% of cases. Low haemoglobin (OR 0.8, 95% CI 0.65-0.99 per g/dL, p = 0.040) and end-stage kidney disease (OR 13.0, CI 2.5-68.5, p = 0.002) remained significant in multivariate analysis. Anaemia (haemoglobin < 12 and < 13 g/dL in female and male patients) increased the risk of complications 2.2-fold.CONCLUSIONS: The major complication rate was low in this high-risk patient population undergoing LAAC. End-stage kidney disease and low baseline haemoglobin were independently associated with a higher major complication rate.

AB - BACKGROUND: As a preventive procedure, minimizing periprocedural risk is crucially important during left atrial appendage closure (LAAC).METHODS: We included consecutive patients receiving LAAC at nine centres and assessed the relationship between baseline characteristics and the acute procedural outcome. Major procedural complications were defined as all complications requiring immediate invasive intervention or causing irreversible damage. Logistic regression was performed and included age and left-ventricular function. Furthermore, the association between acute complications and long-term outcomes was evaluated.RESULTS: A total of 405 consecutive patients with a median age of 75 years (37% female) were included. 47% had a history of stroke. Median CHA2DS2-VASc score was 4 (interquartile range, 3-5) and the median HAS-BLED score was 3 (2-4). Major procedural complications occurred in 7% of cases. Low haemoglobin (OR 0.8, 95% CI 0.65-0.99 per g/dL, p = 0.040) and end-stage kidney disease (OR 13.0, CI 2.5-68.5, p = 0.002) remained significant in multivariate analysis. Anaemia (haemoglobin < 12 and < 13 g/dL in female and male patients) increased the risk of complications 2.2-fold.CONCLUSIONS: The major complication rate was low in this high-risk patient population undergoing LAAC. End-stage kidney disease and low baseline haemoglobin were independently associated with a higher major complication rate.

KW - atrial fibrillation

KW - complications

KW - dialysis

KW - haemoglobin

KW - left atrial appendage closure

UR - http://www.scopus.com/inward/record.url?scp=85141715352&partnerID=8YFLogxK

U2 - 10.3390/jcm11216548

DO - 10.3390/jcm11216548

M3 - Journal article

C2 - 36362774

SN - 2077-0383

VL - 11

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 21

M1 - 6548

ER -

Not to Rush-Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure

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