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  1. Transcatheter aortic valve replacement in patients with chronic kidney disease: a multi-centre retrospective study
    Al Jarallah M, Abdulsalam S, Rajan R, Dashti R, Zhanna KD, Setiya P, et al.
    Ann Med Surg (Lond), 2024 Feb;86(2):697-702.
    PMID: 38333245 DOI: 10.1097/MS9.0000000000001590
    BACKGROUND: Chronic kidney disease (CKD) is a common comorbid condition in patients undergoing transcatheter aortic valve replacement (TAVR). Reported outcome studies on the association of baseline CKD and mortality is currently limited.

    OBJECTIVES: To determine the prevalence of chronic kidney disease in patients undergoing TAVR and analyse their overall procedural outcomes.

    METHODS: This retrospective observational study was conducted at 43 publicly funded hospitals in Hong Kong. Severe aortic stenosis patients undergoing TAVR between the years 2010 and 2019 were enroled in the study. Two groups were identified according to the presence of baseline chronic kidney disease.

    RESULTS: A total of 499 patients (228, 58.6% men) were enroled in the study. Baseline hypertension was more prevalent in patients with CKD (82.8%; P=0.003). As for primary end-points, mortality rates of CKD patients were significantly higher compared to non-CKD patients (10% vs. 4.1%; P=0.04%). Gout and hypertension were found to be significantly associated with CRF. Patients with gout were nearly six times more likely to have CRF than those without gout (odds ratio = 5.96, 95% CI = 3.12-11.29, P<0.001). Patients with hypertension had three times the likelihood of having CRF compared to those without hypertension (odds ratio=2.83, 95% CI=1.45-6.08, P=0.004).

    CONCLUSION: In patients with severe aortic stenosis undergoing TAVR, baseline CKD significantly contributes to mortality outcomes at long-term follow up.

  2. Fulltext Validation of R-hf risk score for risk stratification in ischemic heart failure patients: A prospective cohort study
    Rajan R, Soman SO, Al Jarallah M, Kobalava Z, Dashti R, Al Zakwani I, et al.
    Ann Med Surg (Lond), 2022 Aug;80:104333.
    PMID: 35992211 DOI: 10.1016/j.amsu.2022.104333
    BACKGROUND: The aim of this study was to validate R-heart failure (R-hf) risk score in ischemic heart failure patients.

    METHODS: We prospectively recruited a cohort of 179 ischemic and 107 non-ischemic heart failure patients. This study mainly focused on ischemic heart failure patients. Non-ischemic heart failure patients were included for the purpose of validation of the risk score in various heart failure groups. Patients were stratified in high risk, moderate risk and low risk groups according to R-hf risk score.

    RESULTS: A total of 179 participants with ischemic heart failure were included. Based on R-hf risk score, 82 had high risk, 50 had moderate risk and 47 had low risk heart failure scores. More than half of the patients having R-hf score of <5 had renal failure (n = 91, 50.8%) and anemia (n = 99, 55.3%). Notably, HFrEF was more prevalent in patients with high risk score (74, 90.2%). Patients with high risk score had significantly higher creatinine (2.63 ± 1.96, p 

  3. Fulltext Morbidity and mortality of acute heart failure patients stratified by mitral regurgitation in the Arabian Gulf: Observations from the Gulf acute heart failure registry (Gulf CARE)
    AlObaid L, Rajan R, Al Jarallah M, Dashti R, Bulbanat B, Ridha M, et al.
    Heliyon, 2023 Dec;9(12):e22175.
    PMID: 38076138 DOI: 10.1016/j.heliyon.2023.e22175
    This study aimed to evaluate the clinical outcomes of patients with acute heart failure (AHF) stratified by mitral regurgitation (MR) in the Arabian Gulf. Patients from the Gulf CARE registry were identified from 47 hospitals in seven Arabian Gulf countries (Yemen, Oman, Kuwait, Qatar, Bahrain, the United Arab Emirates, and Saudi Arabia) from February to November 2012. The cohort was stratified into two groups based on the presence of MR. Univariable and multivariable statistical analyses were performed. The population cohort included 5005 consecutive patients presenting with AHF, of whom 1491 (29.8 %) had concomitant MR. The mean age of patients with AHF and concomitant MR was 59.2 ± 14.9 years, and 63.1 % (n = 2886) were male. A total of 58.6 % (n = 2683) had heart failure (HF) with reduced ejection fraction (EF) (HFrEF), 21.0 % (n = 961) had HF with mildly reduced EF (HFmrEF), and 20.4 % (n = 932) had HF with preserved EF (HFpEF). Patients with MR had a lower haemoglobin (Hb) level (12.4 vs. 12.7 g/dL; p 
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