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Online Quantitative Aortographic Assessment of Aortic Regurgitation After TAVR: Results of the OVAL Study Association Between Diastolic Dysfunction and Health Status Outcomes in Patients Undergoing Transcatheter Aortic Valve Replacement Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis Prior Balloon Valvuloplasty Versus Direct Transcatheter Aortic Valve Replacement: Results From the DIRECTAVI Trial Chimney technique in a TAVR-in-TAVR procedure with high risk of left main artery ostium occlusion Timing of intervention in asymptomatic patients with valvular heart disease Meta-Analysis of Effectiveness and Safety of Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Low-to-Intermediate Surgical Risk Cohort Precision Medicine in TAVR: How to Select the Right Device for the Right Patient Prevalence and clinical implications of valvular calcification on coronary computed tomography angiography Raising the Evidentiary Bar for Guideline Recommendations for TAVR: JACC Review Topic of the Week
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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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