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:
CreatorsEmailORCIDORCID Put Code
Schnabel, Renate B.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Seiffert, MoritzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wilde, SandraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schirmer, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Koschyk, Dietmar H.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Conradi, LenardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ojeda, FranciscoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baldus, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reichenspurner, HermannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Blankenberg, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Treede, HendrikUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Diemert, PatrickUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-407553
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:
KeywordsLanguage
ACADEMIC RESEARCH CONSORTIUM; CONTRAST-INDUCED NEPHROPATHY; BODY-MASS INDEX; PROGNOSTIC VALUE; RENAL-FUNCTION; REPLACEMENT; RISK; STENOSIS; OUTCOMES; DISEASEMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/40755

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