Mortality risk factors in patients who are in heart transplantation waiting list
P. A. Fedotov,
M. A. Simonenko,
J. V. Sazonova,
M. A. Bortsova,
A. N. Kostomarov,
M. A. Fedorova,
A. E. Bautin,
G. V. Nikolaev,
M. L. Gordeev,
M. A. Karpenko,
T. M. Pervunina,
M. Y. Sitnikova https://doi.org/10.21886/2712-8156-2022-3-2-41-54
Abstract
Objective: to estimate the survival of patients in the heart transplantation waiting list (HTx WL) at Almazov National Medical Research Centre (V.A. Almazov NMRC), Saint-Petersburg, Russia, from 2010 to 2018 and to define factors for death among these patients.
Materials and methods: it was a single-centre retrospective study involving 151 patients with end-stage chronic heart failure (CHF) classes III-IV (NYHA) in the HTx WL.
Results: the dynamic of decreasing mortality was revealed. Based on the results of constructing the discriminant function, four factors predicting the survival of patients in the HTx WL, namely, ACE inhibitors/ARBs, beta-blockers, status 1 of UNOS, CHF NYHA class IV, were pointed out. The model has sufficient resolving power but is not capable of predicting the outcome in the presence of acute decompensation of CHF.
Conclusion: mortality in the HTx WL for the period 2010-2018 decreased that was associated with an active implementation of cardiac surgical methods as a «bridge» to transplant and optimal medical therapy, including ACE inhibitors/ARBs and beta-blockers in patients supported with inotropes (UNOS 1B). The greatest risk of mortality was found in CHF class IV and status 1 by UNOS.
About the Authors
P. A. Fedotov
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Petr A. Fedotov, Cand. Sci. (Med.), Head of the Research Institute of High-Tech Methods of Heart Failure Treatment, Associate Professor of the Department of Cardiology
Saint-Petersburg
M. A. Simonenko
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Mariya A. Simonenko, Researcher of the Cardiopulmonary Testing Institute, Cardiologist-transplantologist of the CDC
Saint-Petersburg
J. V. Sazonova
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Yuliya V. Sazonova, cardiologist-transplantologist of the Cardiology Department No. 8, junior researcher of the Research Institute of Thoracic Surgery
Saint-Petersburg
M. A. Bortsova
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Mariya A. Borcova, Head of Cardiology Department No. 8
Saint-Petersburg
A. N. Kostomarov
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Artyom N. Kostomarov, Junior Researcher of the Research Institute of High-Tech Methods of Treatment of Heart Failure, cardiologist of the Cardiology Department No. 6
Saint-Petersburg
M. A. Fedorova
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Mariya A. Fedorova, Junior Researcher of the Research Institute of High-Tech Methods of Treatment of Heart Failure, Cardiologist of the Cardiology Department No. 8
Saint-Petersburg
A. E. Bautin
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Andrej E. Bautin, Dr. Sci. (Med.), Associate Professor, Head of the Department of Anesthesiology and Resuscitation, Professor of the Department of Anesthesiology and Resuscitation
Saint-Petersburg
G. V. Nikolaev
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
German V. Nikolaev, Cand. Sci. (Med.), Head of the Research Institute of Thoracic Surgery
Saint-Petersburg
M. L. Gordeev
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Mihail L. Gordeev, Dr. Sci. (Med.), Professor, Head of the Research Department of Cardiothoracic Surgery, Head of the Department of Surgical Diseases
Saint-Petersburg
M. A. Karpenko
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Mihail A. Karpenko, Chairman of the Scientific and Clinical Council, Head of the General Director for Scientific and Therapeutic Work, MD, Professor
Saint-Petersburg
T. M. Pervunina
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Tat’yana M. Pervunina, Dr. Sci. (Med.), Director of the Institute of Perinatology and Pediatrics
Saint-Petersburg
M. Y. Sitnikova
V. A. Almazov National Medical Research Centre
Russian Federation
Russian Federation
Mariya Y. Sitnikova, Dr. Sci. (Med.), Professor, Chief Researcher and Head of the Heart Failure Research Institute, Professor of the Faculty Therapy Department
Saint-Petersburg
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For citations:
Fedotov P.A., Simonenko M.A., Sazonova J.V., Bortsova M.A., Kostomarov A.N., Fedorova M.A., Bautin A.E., Nikolaev G.V., Gordeev M.L., Karpenko M.A., Pervunina T.M., Sitnikova M.Y. Mortality risk factors in patients who are in heart transplantation waiting list. South Russian Journal of Therapeutic Practice. 2022;3(2):41-54. (In Russ.) https://doi.org/10.21886/2712-8156-2022-3-2-41-54
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