PMID- 18439171
OWN - NLM
STAT- MEDLINE
DCOM- 20080528
LR  - 20191210
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 31
IP  - 5
DP  - 2008 May
TI  - Elevated serum creatinine at baseline predicts poor outcome in patients receiving 
      cardiac resynchronization therapy.
PG  - 575-9
LID - 10.1111/j.1540-8159.2008.01043.x [doi]
AB  - BACKGROUND: Renal insufficiency is recognized as a predictor of mortality and 
      poor outcome in heart failure patients. We sought to study the impact of baseline 
      serum creatinine on subsequent outcome in cardiac resynchronization therapy (CRT) 
      recipients. METHODS: We retrospectively reviewed hospital records of all CRT 
      recipients at Pittsburgh Veterans Affairs (VA) Healthcare System (2003-2005) and 
      University of Pittsburgh Medical Center (2004). We recorded clinical 
      characteristics at the time of implantation including demographics, New York 
      Heart Association (NYHA) functional class, ejection fraction, QRS duration, 
      cardiomyopathy etiology, medical history, medication use, and serum creatinine. 
      Mortality alone and mortality combined with heart failure hospitalization were 
      the study endpoints. RESULTS: Out of the 330 patients studied, a total of 66 
      (20.0%) patients died over a mean follow-up duration of 19.7 +/- 9.0 months 
      (range 1-44). The cohort was studied by three creatinine tertiles (0.6-1.0, 
      1.1-1.3, 1.4-3.0 mg/dL). Both study endpoints were observed more frequently in 
      patients in the highest creatinine tertile compared to others (28.7% vs 14.0%, P 
      = 0.008 for death and 41.6% vs 21.5%, P = 0.001 for the combined endpoint). High 
      creatinine remained an independent predictor of mortality (hazard ratio [HR] 
      1.89, 95% confidence interval [CI] 1.06-3.39, P = 0.032) and the combined 
      endpoint (HR 1.94, 95% CI 1.20-3.13, P = 0.007) in multivariate adjusted models. 
      Studied as a continuous variable, increase in creatinine level by 0.1 mg/dL was 
      associated with an 11% increase in mortality risk and a 7% increase in the 
      combined endpoint. CONCLUSION: In an unselected cohort of CRT recipients, the 
      baseline creatinine was found to predict worse survival and poor outcome over a 
      modest follow-up duration.
FAU - Shalaby, Alaa
AU  - Shalaby A
AD  - Division of Cardiology, VA Pittsburgh Healthcare System, Pittsburgh, PA 15240, 
      USA. alaa.shalaby@med.va.gov
FAU - El-Saed, Aiman
AU  - El-Saed A
FAU - Voigt, Andrew
AU  - Voigt A
FAU - Albany, Constantine
AU  - Albany C
FAU - Saba, Samir
AU  - Saba S
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
RN  - 0 (Biomarkers)
RN  - AYI8EX34EU (Creatinine)
SB  - IM
MH  - Aged
MH  - Biomarkers/blood
MH  - Cardiac Pacing, Artificial/*mortality
MH  - Cohort Studies
MH  - Creatinine/*blood
MH  - Heart Failure/blood/mortality/prevention & control
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Outcome Assessment, Health Care/*methods
MH  - Pacemaker, Artificial/statistics & numerical data
MH  - Pennsylvania/epidemiology
MH  - Prognosis
MH  - Renal Insufficiency/*blood/diagnosis/*mortality
MH  - Reproducibility of Results
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Sensitivity and Specificity
MH  - Survival Analysis
MH  - Survival Rate
MH  - Treatment Outcome
EDAT- 2008/04/29 09:00
MHDA- 2008/05/29 09:00
CRDT- 2008/04/29 09:00
PHST- 2008/04/29 09:00 [pubmed]
PHST- 2008/05/29 09:00 [medline]
PHST- 2008/04/29 09:00 [entrez]
AID - PACE1043 [pii]
AID - 10.1111/j.1540-8159.2008.01043.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2008 May;31(5):575-9. doi: 
      10.1111/j.1540-8159.2008.01043.x.