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Early Surgery or Conservative Care for Asymptomatic Aortic Stenosis Association Between Diastolic Dysfunction and Health Status Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement Increased Risk of Valvular Heart Disease in Systemic Sclerosis: An Underrecognized Cardiac Complication Comparison of safety and periprocedural complications of transfemoral aortic valve replacement under local anaesthesia: minimalist versus complete Heart Team Relationship Between Hospital Surgical Aortic Valve Replacement Volume and Transcatheter Aortic Valve Replacement Outcomes Poor Long-Term Survival in Patients With Moderate Aortic Stenosis Suture- or Plug-Based Large-Bore Arteriotomy Closure: A Pilot Randomized Controlled Trial Transcatheter Aortic Valve Replacement vs Surgical Replacement in Patients With Pure Aortic Insufficiency 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines Timing of intervention in asymptomatic patients with valvular heart disease
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Original Research2021 Jan 14;S0002-8703(21)00011-9.

JOURNAL：Am Heart J. Article Link

Late kidney injury after transcatheter aortic valve replacement

Y Adachi, M Yamamoto, OCEAN-TAVI investigators et al. Keywords: late kidney injury; TAVR; clinical outcome

ABSTRACT

BACKGROUND - Information on early to late-phase kidney damage in patients who underwent transcatheter aortic valve replacement (TAVR) is scarce. We aimed to identify the predictive factors for late kidney injury (LKI) at 1-year and patient prognosis beyond 1-year after TAVR.

 

METHODS - We retrospectively reviewed 1705 patients’ data from the Japanese TAVR multicenter registry. Acute kidney injury (AKI) and LKI, defined as an increase of at least 0.3 mg/dl in creatinine level, a relative 50% decrease in kidney function from baseline to 48-hours and 1-year, were evaluated. The patients were categorized into the four groups as AKI- /LKI- (n=1362), AKI+ /LKI- (n=95), AKI- /LKI+ (n=199), and AKI+ /LKI+ (n=46).

 

RESULTS - The cumulative 3-year mortality rates were significantly increased across the four groups (12.5%, 15.8%, 24.6%, 25.8%, p<0.001). Multivariate analysis revealed that chronic kidney disease, coronary artery disease, peri-procedural AKI, and heart failure-related re-admission within 1-year were significantly associated with LKI. The Cox regression analysis revealed that AKI- /LKI+ and AKI+ /LKI+ were independent predictors of increased late mortality beyond 1-year after TAVR (p=0.001 and p=0.01).

 

CONCLUSION - LKI was influenced by adverse cardio-renal events and was associated with increased risks of late mortality beyond 1-year after TAVR.

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