Clinical InvestigationValvular and Congenital Heart DiseaseIncidence and predictors of acute kidney injury after transcatheter aortic valve replacement
Section snippets
Methods
This prospective study was approved by the institutional review board of the MedStar Health Research Institute. Consecutive patients with symptomatic severe aortic stenosis who underwent TAVR as part of the PARTNER trials from May 2007 to May 2011 were analyzed for periprocedural AKI.
Prespecified clinical and laboratory data were prospectively collected for all patients on admission, immediately post-TAVR, and during long-term follow-up. Collected data included medical history, medications on
Results
Throughout the study period, a total of 165 patients with severe, symptomatic aortic stenosis underwent TAVR. The average age was 85 ± 6 years, and 42% of the patients were male. The average Society of Thoracic Surgeons risk score was 12% ± 4% with multiple comorbidities; 96% had systemic hypertension, 32% had diabetes, 56% had history of coronary artery disease, 27% had peripheral vascular disease, and 78% had chronic renal insufficiency. The baseline eGFR of this patient cohort was 49 ± 20 mL
Discussion
The main findings of the present study indicate that AKI after TAVR is a frequent complication, which occurs in >10% of patients. These patients have significantly worse outcome. The prohibitive mortality rates of patients who developed AKI were also identified by previous reports that also demonstrated that the 30-day (6.9%-23%)13, 18 and 1-year (54.8%-60%)12, 19 mortality is higher for these patients. It is, thus, imperative to identify patients at risk and to minimize their risks for AKI.
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