Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure
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 o...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/21/6548 |
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| author | 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 |
| author_facet | 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 |
| author_sort | David Zweiker |
| collection | DOAJ |
| description | 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, <i>p</i> = 0.040) and end-stage kidney disease (OR 13.0, CI 2.5–68.5, <i>p</i> = 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. |
| first_indexed | 2024-03-09T18:57:26Z |
| format | Article |
| id | doaj.art-2860edd92dc444fd9aa660c04ccdc386 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T18:57:26Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-2860edd92dc444fd9aa660c04ccdc3862023-11-24T05:19:27ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011121654810.3390/jcm11216548Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage ClosureDavid Zweiker0Lukas Fiedler1Gabor G. Toth2Andreas Strouhal3Georg Delle-Karth4Guenter Stix5Harald Gabriel6Ronald K. Binder7Martin Rammer8Michael Pfeffer9Paul Vock10Brigitte Lileg11Clemens Steinwender12Kurt Sihorsch13Florian Hintringer14Silvana Mueller15Fabian Barbieri16Martin Martinek17Wolfgang Tkalec18Nicolas Verheyen19Klemens Ablasser20Andreas Zirlik21Daniel Scherr22Department of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Internal Medicine, Cardiology and Nephrology, Hospital Wiener Neustadt, 2700 Wiener Neustadt, AustriaDepartment of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Cardiology, Hospital Nord–Klinik Floridsdorf, 1210 Vienna, AustriaDepartment of Cardiology, Hospital Nord–Klinik Floridsdorf, 1210 Vienna, AustriaDepartment of Internal Medicine II, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Internal Medicine II, Medical University of Vienna, 1090 Vienna, AustriaDepartment of Internal Medicine II, Klinikum Wels-Grieskirchen, 4600 Wels, AustriaDepartment of Internal Medicine II, Klinikum Wels-Grieskirchen, 4600 Wels, AustriaDepartment of Internal Medicine, Cardiology and Nephrology, Hospital Wiener Neustadt, 2700 Wiener Neustadt, AustriaDepartment of Internal Medicine III, University Hospital St. Pölten, 3100 St. Pölten, AustriaDepartment of Internal Medicine III, University Hospital St. Pölten, 3100 St. Pölten, AustriaDepartment of Cardiology, Kepler University Hospital, 4020 Linz, AustriaDepartment of Cardiology, Kepler University Hospital, 4020 Linz, AustriaDepartment of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Internal Medicine III, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Internal Medicine II, Elisabethinen Hospital, 4020 Linz, AustriaDepartment of Internal Medicine II, Elisabethinen Hospital, 4020 Linz, AustriaDepartment of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Cardiology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaBackground: 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, <i>p</i> = 0.040) and end-stage kidney disease (OR 13.0, CI 2.5–68.5, <i>p</i> = 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.https://www.mdpi.com/2077-0383/11/21/6548left atrial appendage closureatrial fibrillationcomplicationshaemoglobindialysis |
| spellingShingle | 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 Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure Journal of Clinical Medicine left atrial appendage closure atrial fibrillation complications haemoglobin dialysis |
| title | Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure |
| title_full | Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure |
| title_fullStr | Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure |
| title_full_unstemmed | Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure |
| title_short | Not to Rush—Laboratory Parameters and Procedural Complications in Patients Undergoing Left Atrial Appendage Closure |
| title_sort | not to rush laboratory parameters and procedural complications in patients undergoing left atrial appendage closure |
| topic | left atrial appendage closure atrial fibrillation complications haemoglobin dialysis |
| url | https://www.mdpi.com/2077-0383/11/21/6548 |
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