Impact of acute kidney Injury on short-and long-term outcomes after transcatheter aortic valve implantation
Rev. esp. de cardiol. (Internet. Engl. ed.)
; 72(1): 21-29, Jan. 2019. tab, graf
Artigo
em Inglês
| Sec. Est. Saúde SP, SESSP-IDPCPROD, Sec. Est. Saúde SP
| ID: biblio-1023736
Biblioteca responsável:
BR79.1
ABSTRACT
Acute kidney injury (AKI) is frequently observed after transcatheter aortic valve implantation (TAVI) and is associated with higher mortality. However, the impact of AKI on long-term outcomes remains controversial. Therefore, we sought to evaluate the impact of AKI on short- and long-term outcomes following TAVI using the Valve Academic Research Consortium 2 criteria. METHODS:
Consecutive patients (n = 794) with severe aortic stenosis who underwent TAVI were included in a multicenter Brazilian registry. Logistic regression analysis was used to identify predictors of AKI. Four-year outcomes were determined as Kaplan-Meier survival curves, and an adjusted landmark analysis was used to test the impact of AKI on mortality among survivors at 12 months.RESULTS:
The incidence of AKI after TAVI was 18%. Independent predictors of AKI were age, diabetes mellitus, major or life-threatening bleeding and valve malpositioning. Acute kidney injury was independently associated with higher risk of all-cause death (adjusted HR, 2.8; 95%CI, 2.0-3.9; P < .001) and cardiovascular mortality (adjusted HR, 2.9; 95%CI, 1.9-4.4; P < .001) over the entire follow-up period. However, when considering only survivors at 12 months, there was no difference in both clinical endpoints (adjusted HR, 1.2; 95%CI, 0.5-2.4; P = .71, and HR, 0.7; 95%CI, 0.2-2.1; P = .57, respectively).CONCLUSIONS:
Acute kidney injury is a frequent complication after TAVI. Older age, diabetes, major or life-threatening bleeding, and valve malpositioning were independent predictors of AKI. Acute kidney injury is associated with worse short- and long-term outcomes. However, the major impact of AKI on mortality is limited to the first year after TAVI. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved. KEYWORDS Acute kidney injury; Aortic stenosis; Daño renal agudo; Edad avanzada; Elderly; Estenosis aórtica; Implante percutáneo de válvula aórtica; Mortalidad; Mortality; Transcatheter aortic valve implantation; Valve Academic Research Consortium.
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Coleções:
Bases de dados nacionais
/
Brasil
Base de dados:
Sec. Est. Saúde SP
/
SESSP-IDPCPROD
Assunto principal:
Injúria Renal Aguda
/
Substituição da Valva Aórtica Transcateter
Tipo de estudo:
Estudo prognóstico
Limite:
Humanos
Idioma:
Inglês
Revista:
Rev. esp. de cardiol. (Internet. Engl. ed.)
Ano de publicação:
2019
Tipo de documento:
Artigo
Instituição/País de afiliação:
Cleveland Medical Center/US
/
Hospital Israelita Albert Einstein/BR
/
Hospital Pró-Cardíaco/BR
/
Hospital São Marcos/BR
/
Hospital São Vicente de Paulo/BR
/
Instituto Dante Pazzanese de Cardiologia/BR
/
Instituto de Cardiologia/BR
/
Rede D'OR São Luiz/BR
/
University of São Paulo Medical School/BR