TY - JOUR
T1 - Usefulness of updated valve academic research consortium-2 criteria for acute kidney injury following transcatheter aortic valve implantation
AU - Konigstein, Maayan
AU - Ben-Assa, Eyal
AU - Abramowitz, Yigal
AU - Steinvil, Arie
AU - Leshem Rubinow, Eran
AU - Havakuk, Ofer
AU - Arbel, Yaron
AU - Halkin, Amir
AU - Keren, Gad
AU - Banai, Shmuel
AU - Finkelstein, Ariel
PY - 2013/12/1
Y1 - 2013/12/1
N2 - Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is frequent and associated with adverse outcomes. We aimed to identify the incidence and risk factors for AKI after TAVI using the updated Valve Academic Research Consortium-2 classification criteria. We performed a retrospective analysis of 300 consecutive patients undergoing TAVI using either Edwards SAPIEN XT or CoreValve bioprostheses at our medical center. Change in serum creatinine from base line to 48 to 72 hours after TAVI was used to define AKI stages 1 to 3. The final study cohort included 251 patients. Overall incidence of AKI was 16.7% (42 of 251); of which, stage 1 AKI was 15.1% (38 of 251), stage 2 AKI was 1.6% (4 of 251), and none had stage 3 AKI or required hemodialysis. All-cause mortality at 30 days and 1 year was greater among patients with AKI (9.5% vs 1%, p <0.01% and 25.7% vs 12.3%, p = 0.041, respectively). Despite greater volume of contrast media used in Edwards SAPIEN versus CoreValve (162 ml vs 142 ml, p = 0.02), there was no difference in the incidence of AKI between the 2 valve types (23.7% vs 15.5%, p = 0.238) or when comparing larger (29 to 31 mm) versus smaller size valves (23 to 26 mm; 17.7% vs 16.1%, p = 0.745). AKI was associated with chronic kidney disease, history of peripheral vascular disease, blood transfusion, and higher EuroSCORE (p <0.05 for all). In conclusion, according to the new Valve Academic Research Consortium-2 classification, 1 in every 6 patients in our cohort developed AKI after TAVI (most were stage 1 AKI). AKI was associated with increased mortality. No difference in AKI incidence was observed between different types and sizes of bioprostheses used.
AB - Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is frequent and associated with adverse outcomes. We aimed to identify the incidence and risk factors for AKI after TAVI using the updated Valve Academic Research Consortium-2 classification criteria. We performed a retrospective analysis of 300 consecutive patients undergoing TAVI using either Edwards SAPIEN XT or CoreValve bioprostheses at our medical center. Change in serum creatinine from base line to 48 to 72 hours after TAVI was used to define AKI stages 1 to 3. The final study cohort included 251 patients. Overall incidence of AKI was 16.7% (42 of 251); of which, stage 1 AKI was 15.1% (38 of 251), stage 2 AKI was 1.6% (4 of 251), and none had stage 3 AKI or required hemodialysis. All-cause mortality at 30 days and 1 year was greater among patients with AKI (9.5% vs 1%, p <0.01% and 25.7% vs 12.3%, p = 0.041, respectively). Despite greater volume of contrast media used in Edwards SAPIEN versus CoreValve (162 ml vs 142 ml, p = 0.02), there was no difference in the incidence of AKI between the 2 valve types (23.7% vs 15.5%, p = 0.238) or when comparing larger (29 to 31 mm) versus smaller size valves (23 to 26 mm; 17.7% vs 16.1%, p = 0.745). AKI was associated with chronic kidney disease, history of peripheral vascular disease, blood transfusion, and higher EuroSCORE (p <0.05 for all). In conclusion, according to the new Valve Academic Research Consortium-2 classification, 1 in every 6 patients in our cohort developed AKI after TAVI (most were stage 1 AKI). AKI was associated with increased mortality. No difference in AKI incidence was observed between different types and sizes of bioprostheses used.
UR - http://www.scopus.com/inward/record.url?scp=84888007649&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2013.07.048
DO - 10.1016/j.amjcard.2013.07.048
M3 - Article
AN - SCOPUS:84888007649
SN - 0002-9149
VL - 112
SP - 1807
EP - 1811
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -