Document Detail


Usefulness of the INTERMACS Scale for Predicting Outcomes After Urgent Heart Transplantation.
MedLine Citation:
PMID:  21316834     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
INTRODUCTION AND OBJECTIVES: Our aim was to assess the prognostic value of the INTERMACS (Interagency Registry for Mechanically Assisted Circulatory Support) scale in patients undergoing urgent heart transplantation (HT). METHODS: Retrospective analysis of 111 patients treated with urgent HT at our institution from April, 1991 to October, 2009. Patients were retrospectively assigned to three levels of the INTERMACS scale according to their clinical status before HT. RESULTS: Patients at the INTERMACS 1 level (n=31) more frequently had ischemic heart disease (P=.03) and post-cardiothomy shock (P=.02) than patients at the INTERMACS 2 (n=55) and INTERMACS 3-4 (n=25) levels. Patients at the INTERMACS 1 level showed higher preoperative catecolamin doses (P=.001), a higher frequency of use of mechanical ventilation (P<.001), intraaortic balloon (P=.002) and ventricular assist devices (P=.002), and a higher frequency of preoperative infection (P=.015). The INTERMACS 1 group also presented higher central venous pressure (P=.02), AST (P=.002), ALT (P=.006) and serum creatinine (P<.001), and lower hemoglobin (P=.008) and creatinine clearance (P=.001). After HT, patients at the INTERMACS 1 level had a higher incidence of primary graft failure (P=.03) and postoperative need for renal replacement therapy (P=.004), and their long-term survival was lower than patients at the INTERMACS 2 (log rank 5.1, P=.023; HR 3.1, IC 95% 1.1-8.8) and INTERMACS 3-4 level (log rank 6.1, p=0.013; HR 6.8, IC 95% 1.2-39.1). CONCLUSIONS: Our results suggest that the INTERMACS scale may be a useful tool to stratify postoperative prognosis after urgent HT. Full English text available from: www.revespcardiol.org.
Authors:
Eduardo Barge-Caballero; María J Paniagua-Martín; Raquel Marzoa-Rivas; Rosa Campo-Pérez; José Ángel Rodríguez-Fernández; Alberto Pérez-Pérez; Lourdes García-Bueno; Paula Blanco-Canosa; Zulaika Grille Cancela; Miguel Solla Buceta; Alberto Juffé-Stein; José M Herrera-Noreña; José J Cuenca-Castillo; Javier Muñiz; Alfonso Castro-Beiras; María G Crespo-Leiro
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-11
Journal Detail:
Title:  Revista espanola de cardiologia     Volume:  -     ISSN:  1579-2242     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-14     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0404277     Medline TA:  Rev Esp Cardiol     Country:  -    
Other Details:
Languages:  ENG; SPA     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.
Affiliation:
Unidad de Trasplante Cardiaco, Hospital Universitario de A Coruña, A Coruña, España.
Vernacular Title:
Utilidad de la escala INTERMACS para estratificar el pronóstico tras el trasplante cardiaco urgente.
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