Universität zu Köln

Schnabel, Renate B., Seiffert, Moritz, Wilde, Sandra, Schirmer, Johannes, Koschyk, Dietmar H., Conradi, Lenard, Ojeda, Francisco, Baldus, Stephan, Reichenspurner, Hermann, Blankenberg, Stefan, Treede, Hendrik and Diemert, Patrick (2015). Kidney Injury and Mortality after Transcatheter Aortic Valve Implantation in a Routine Clinical Cohort. Catheter. Cardiovasc. Interv., 85 (3). S. 440 - 448. HOBOKEN: WILEY-BLACKWELL. ISSN 1522-726X

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Abstract

ObjectivesWe aimed at identifying predictors of renal impairment and its impact on long-term outcome after transcatheter aortic valve implantation (TAVI). BackgroundRenal impairment is common in mostly elderly, multimorbid patients undergoing TAVI. The risk of periprocedural renal function impairment and its association with outcome is incompletely understood. MethodsIn 458 consecutive patients (mean age, 80.67.0 years, 52.2% women) who underwent routine TAVI procedures, we assessed estimated glomerular filtration rate (eGFR) at baseline, during 72-hr postprocedure and at discharge. Over a median follow-up of 0.96 years, we observed 142 deaths. Results: In multivariable-adjusted models, predictors of renal function deterioration within 72 hr were baseline eGFR (=0.83, 95% confidence interval [CI]=0.76/0.91; P<0.0001), body mass index (=-1.20, 95% CI=1.77/-0.62; P<0.0001), and major access site complications (=-14.82, 95% CI=-26.52/-3.11; P=0.013) including bleeding (=-11.97, 95% CI=-21.05/-2.89; P=0.0099). Strongest renal function predictor of 1-year mortality in risk factor adjusted analyses was the change of eGFR within 72 hr (odds ratio, 0.97; 95% CI=0.96/0.98; P<0.0001). The addition of information on the change of eGFR increased the C-statistic of the logistic EuroSCORE (P=0.021). ConclusionsIn our routine TAVI sample, baseline eGFR, body mass index, and major access site complications mainly owing to bleeding were correlates of acute kidney injury after TAVI. Acute renal impairment was a risk factor for mortality and adverse cardiovascular events which provided risk information beyond the EuroSCORE. (c) 2014 Wiley Periodicals, Inc.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Schnabel, Renate B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Seiffert, Moritz UNSPECIFIED UNSPECIFIED UNSPECIFIED Wilde, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Schirmer, Johannes UNSPECIFIED UNSPECIFIED UNSPECIFIED Koschyk, Dietmar H. UNSPECIFIED UNSPECIFIED UNSPECIFIED Conradi, Lenard UNSPECIFIED UNSPECIFIED UNSPECIFIED Ojeda, Francisco UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Reichenspurner, Hermann UNSPECIFIED UNSPECIFIED UNSPECIFIED Blankenberg, Stefan UNSPECIFIED UNSPECIFIED UNSPECIFIED Treede, Hendrik UNSPECIFIED UNSPECIFIED UNSPECIFIED Diemert, Patrick UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-412440
DOI:	10.1002/ccd.25588
Journal or Publication Title:	Catheter. Cardiovasc. Interv.
Volume:	85
Number:	3
Page Range:	S. 440 - 448
Date:	2015
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1522-726X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language ACADEMIC RESEARCH CONSORTIUM; CONTRAST-INDUCED NEPHROPATHY; BODY-MASS INDEX; PROGNOSTIC VALUE; RENAL-FUNCTION; REPLACEMENT; RISK; STENOSIS; OUTCOMES; DISEASE Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41244