Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic valve replacement

作者：Rodrigo Bagur, John G. Webb, Fabian Nietlispach, Éric Dumont, Robert De Larochellière, Daniel A. Doyle, J.-B. Masson, M. J. Gutiérrez, Marie-Annick A Clavel, Olivier Francois Bertrand, Phillipe Pibarot, Josep Rodés‐Cabau · 发表于：European Heart Journal · 年份：2009 · DOI：10.1093/eurheartj/ehp552 · 被引用次数：489 · 研究领域：Cardiac Valve Diseases and Treatments、Aortic Disease and Treatment Approaches、Mechanical Circulatory Support Devices

AIMS: Very few data exist on the occurrence of acute kidney injury (AKI) associated with transcatheter aortic valve implantation (TAVI). The objectives of the present study were (i) to determine the incidence, predictive factors, and prognostic value of AKI following TAVI, and (ii) to compare the occurrence of AKI in TAVI vs. surgical aortic valve replacement (SAVR) in patients with pre-procedural chronic kidney disease (CKD). METHODS AND RESULTS: A total of 213 patients (mean age 82 +/- 8 years) undergoing TAVI for the treatment of severe aortic stenosis were included in the study. Acute kidney injury was defined as a reduction of >25% in estimated glomerular filtration rate (eGFR) within 48 h following the procedure or the need for haemodialysis during index hospitalization. Those patients with pre-procedural CKD (eGFR <60 mL/min/1.73 m(2), n = 119) were compared with 104 contemporary patients with CKD who underwent isolated SAVR. The incidence of AKI following TAVI was 11.7%, with 1.4% of the patients requiring haemodialysis. Predictive factors of AKI were hypertension (OR: 4.66; 95% CI: 1.04-20.87), chronic obstructive pulmonary disease (OR: 2.64, 95% CI: 1.10-6.36), and peri-operative blood transfusion (OR: 3.47, 95% CI: 1.30-9.29). Twenty-one patients (9.8%) died during index hospitalization, and the logistic EuroSCORE (OR: 1.03 for each increase of 1%; 95% CI: 1.01-1.06) and occurrence of AKI (OR: 4.14, 95% CI: 1.42-12.13) were identified as independent predictors of p...