Universität zu Köln

Mas-Peiro, Silvia ORCID: 0000-0002-3828-8180, Faerber, Gloria, Bon, Dimitra, Herrmann, Eva, Bauer, Timm, Bleiziffer, Sabine, Bekeredjian, Raffi, Boning, Andreas, Frerker, Christian, Beckmann, Andreas, Mollmann, Helge, Vasa-Nicotera, Mariuca, Ensminger, Stephan ORCID: 0000-0002-9508-3261, Hamm, Christian W., Beyersdorf, Friedhelm ORCID: 0000-0003-2975-2751, Fichtlscherer, Stephan and Walther, Thomas (2021). Impact of chronic kidney disease in 29 893 patients undergoing transcatheter or surgical aortic valve replacement from the German Aortic Valve Registry. Eur. J. Cardio-Thorac. Surg., 59 (3). S. 532 - 545. CARY: OXFORD UNIV PRESS INC. ISSN 1873-734X

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Abstract

OBJECTIVES: Chronic kidney disease (CKD) is a key risk factor in patients undergoing transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR). We analysed the impact of estimated glomerular filtration rate (eGFR) and CKD stages on their mid-term survival. METHODS: Data from 29 893 patients enrolled in the German Aortic Valve registry from January 2011 to December 2015 receiving TAVI (n=12 834) or SAVR (n=17 059) at 88 sites were included. The impact of renal impairment, as measured by eGFR and CKD stages, was investigated. The primary end-point was 1-year cumulative all-cause mortality. RESULTS: Higher CKD stages were significantly associated to lower in-hospital, 30-day- and 1-year survival rates. Both TAVI- and SAVR-treated patients in CKD 3a, 3b, 4 and 5 stages showed significant and gradually increasing HR values for 1-year all-cause mortality. The same trend persisted in multivariable analysis, although HR values for CKD 3a and 5 did not reach significance in TAVI patients, whereas CKD 4+5 did not reach statistical significance in SAVR. Likewise, eGFR as a continuous variable was a significant predictor for 1-year mortality, with the best cut-off points being 47.4ml/min/1.73 m(2) for TAVI and 59.8ml/min/1.73 m(2) for SAVR. Significant 8.6% and 9.0% increases in 1-year mortality were observed for every 5-ml reduction in eGFR for TAVI and SAVR, respectively. CONCLUSIONS: CKD >= 3b and CKD >= 3a are the independent major risk factors for mortality in patients undergoing TAVI and SAVR, respectively. In the overall population of patients with severe aortic stenosis, an appropriate stratification based on CKD substage may contribute to a better selection of patients suitable for such therapies.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mas-Peiro, Silvia UNSPECIFIED orcid.org/0000-0002-3828-8180 UNSPECIFIED Faerber, Gloria UNSPECIFIED UNSPECIFIED UNSPECIFIED Bon, Dimitra UNSPECIFIED UNSPECIFIED UNSPECIFIED Herrmann, Eva UNSPECIFIED UNSPECIFIED UNSPECIFIED Bauer, Timm UNSPECIFIED UNSPECIFIED UNSPECIFIED Bleiziffer, Sabine UNSPECIFIED UNSPECIFIED UNSPECIFIED Bekeredjian, Raffi UNSPECIFIED UNSPECIFIED UNSPECIFIED Boning, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Frerker, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Beckmann, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Mollmann, Helge UNSPECIFIED UNSPECIFIED UNSPECIFIED Vasa-Nicotera, Mariuca UNSPECIFIED UNSPECIFIED UNSPECIFIED Ensminger, Stephan UNSPECIFIED orcid.org/0000-0002-9508-3261 UNSPECIFIED Hamm, Christian W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Beyersdorf, Friedhelm UNSPECIFIED orcid.org/0000-0003-2975-2751 UNSPECIFIED Fichtlscherer, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Walther, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-602948
DOI:	10.1093/ejcts/ezaa446
Journal or Publication Title:	Eur. J. Cardio-Thorac. Surg.
Volume:	59
Number:	3
Page Range:	S. 532 - 545
Date:	2021
Publisher:	OXFORD UNIV PRESS INC
Place of Publication:	CARY
ISSN:	1873-734X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language IMPLANTATION TAVI; RENAL DYSFUNCTION; HIGH-RISK; OUTCOMES; STENOSIS; ASSOCIATION; MORTALITY; SURVIVAL; THERAPY Multiple languages Cardiac & Cardiovascular Systems; Respiratory System; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/60294