Glomerular filtration rate and association to stroke, major XXXX , and @entity204 in @entity1 with mechanical heart valve prosthesis.

@entity1 @entity548 @entity1031 @entity340 @entity204
AIMS: The impact of estimated glomerular filtration rate (eGFR) on adverse events in @entity1 with @entity340 ( @entity340 ) is unknown. We analyzed the independent association of eGFR and @entity1031 ( @entity1031 ), major @entity548 , and mortality in @entity1 with MHV in an observational cohort study. METHODS AND RESULTS: All @entity1 (n = 520) with MHV replacement on anticoagulation treatment were followed up prospectively regarding @entity1031 , major @entity548 , and @entity204 at 2 anticoagulation centers during 2008 to 2011. The mean age was 69 years, 72% with aortic valve replacement, and time in therapeutic range 2.0 to 4.0 was 91%. The incidence of the combined end point of major @entity548 , @entity1031 , and @entity204 increased sharply with each decreasing eGFR stratum: 5.5, 8.4, 16, and 32 per 100 @entity1 -years for eGFR >60, 45 to 60, 30 to 45, and <30 mL/min per 1.73 m(2), respectively. After multivariate adjustment for comorbidities, every unit decrease in eGFR increased the risk of major @entity548 by 2%, @entity204 by 3%, and the combined end point by 1%. There was no association between eGFR and @entity1031 . There was an increased proportion of international normalized ratio >3.0 and >4.0 and decreasing time in therapeutic range for each decreasing eGFR stratum (P < .001 for trend). The hazard ratios of the combined end point for eGFR <30, 30 to 45, and 45 to 60 mL/min per 1.73 m(2) were 3.2 (95% CI 1.8-5.6), 1.5 (95% CI 0.9-2.5), and 0.9 (95% CI 0.6-1.5), respectively, compared to eGFR >60 mL/min per 1.73 m(2). CONCLUSION: In @entity1 with MHV on anticoagulation, eGFR is an independent predictor of major @entity548 and @entity204 and not @entity1031 .
