Acute kidney injury and Acute kidney recovery following TAVR: Conflicting results with regards to earlier studies - 09/01/21
, B. Marchandot, K. Matsushita, E. Prinz, S. Hess, A. Reydel Dedieu, A. Carmona, J. Heger, A. Trimaille, H. Petit-Eisenmann, A. Trinh, L. Jesel, P. Ohlmann, O. Morel
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Résumé |
Background and purpose |
Acute kidney injury (AKI) remains associated with a dismal prognosis in TAVR. Acute kidney recovery (AKR), a phenomenon reverse to AKI has recently been associated with better outcomes.
Methods |
Between November 2012 to May 2018, we explored consecutive patients referred to our Heart Valve Center for TAVR. AKI was defined according to the VARC-2 definition. Mirroring the VARC-2 definition of AKI, AKR was defined as a decrease in serum creatinine (≥50%) or ≥25% improvement in GFR up to 72hours after TAVR.
Results |
AKI and AKR were respectively observed in 8.3 and 15.7% of the 574 patients included. AKI and AKR patients were associated to more advanced kidney disease at baseline. At a median follow-up of 608 days (range 355–893), AKI and AKR patients experienced an increased cardiovascular mortality compared to unchanged renal function patients (14.6% and 17.8% respectively, vs. 8.1%, CI 95%, P<0.022). Chronic kidney disease, (HR: 3.9; 95% CI 1.7–9.2; P<0.001) was the strongest independent factor associated with AKI similarly as baseline creatinine level (HR: 1; 95% CI 1 to 1.1 P<0.001) for AKR. 72-hours post procedural AKR (HR: 2.26; 95% CI 1.14 to 4.88; P=0.021) was the strongest independent predictor of CV mortality (Fig. 1).
Conclusions |
72-hours post procedural AKR patients are a subgroup of patients at high risk of post TAVR cardiovascular complications
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Vol 13 - N° 1
P. 73 - janvier 2021 Retour au numéro
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