Abstract 145: Rates of Transfusion and Progression to End-Stage Renal Disease in Chronic Kidney Disease Patients Undergoing Transradial Versus Transfemoral Cardiac Catheterization - An Analysis from the VA CART Program
| Autor: | Maggie A. Stanislawski, Walter W. Woody, John S. Rumsfeld, Brahmajee K. Nallamothu, Amit N. Vora, Thomas M. Maddox, Mladen I. Vidovich, Sunil V. Rao |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
education.field_of_study Blood transfusion business.industry medicine.medical_treatment Population Renal function medicine.disease End stage renal disease Surgery Internal medicine Cardiology Medicine Cardiology and Cardiovascular Medicine business education Veterans Affairs Dialysis Cardiac catheterization Kidney disease |
| Zdroj: | Circulation: Cardiovascular Quality and Outcomes. 7 |
| ISSN: | 1941-7705 1941-7713 |
| DOI: | 10.1161/circoutcomes.7.suppl_1.145 |
| Popis: | Background: Patients with chronic kidney disease (CKD) are at increased risk of bleeding and transfusion after cardiac catheterization. Whether rates of these complications or progression to new dialysis are increased in this high-risk population undergoing transradial (TR) access compared to transfemoral (TF) access is unknown. Methods: From the Veterans Affairs Clinical Assessment, Reporting, and Tracking (CART) Program between 10/2007-09/2012 we identified 40,160 CKD patients undergoing cardiac catheterization with baseline glomerular filtration rate (GFR) ≤ 60 ml/min. We used multivariable Cox modeling to determine the independent association between TR access and post-procedure transfusion as well as progression to new dialysis using TF as the reference. Results: Overall, 3,828 (9.5%) of CKD patients underwent TR access and tended to be slightly younger but overall had similar rates of CKD severity compared with TF patients (GFR 45-60 ml/min: 77.0% vs. 77.0%; GFR 30-44 ml/min: 19.7% vs. 19.3%; GFR 15-29 ml/min: 3.3% vs. 3.7%, p=0.35). TR patients had longer fluoroscopy times (8.1 vs 6.9 minutes, p= Conclusion: Among CKD patients undergoing cardiac catheterization in the VA health system, TR access is associated with a decreased risk for post-procedure transfusion compared with TF access. There was no significant difference between the two approaches with respect to progression to ESRD. These data suggest that TR is a reasonable option for patients with any level of CKD undergoing cardiac catheterization. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|