Acute kidney injury after transcatheter aortic valve implantation: Impact of contrast agents, predictive factors, and prognostic importance in 203 patients with long-term follow-up

被引:30
作者
Chatani, Kenichi [1 ]
Abdel-Wahab, Mohamed [1 ]
Wuebken-Kleinfeld, Nora [1 ]
Gordian, Ken [1 ]
Poetzing, Kathrin [1 ]
Mostafa, Ahmad E. [1 ]
Kraatz, Ernst-Guenter [2 ]
Richardt, Doreen [3 ]
El-Mawardy, Mohamed [1 ]
Richardt, Gert [1 ]
机构
[1] Segeberger Kliniken GmbH, Ctr Heart, Dept Cardiol, D-23795 Bad Segeberg, Germany
[2] Segeberger Kliniken GmbH, Ctr Heart, Dept Cardiovasc Surg, D-23795 Bad Segeberg, Germany
[3] Univ Hosp Schleswig Holstein, Dept Cardiovasc Surg, Lubeck, Germany
关键词
Transcatheter aortic valve implantation; Acute kidney injury; Contrast medium; Long-term clinical outcome; PERCUTANEOUS CORONARY INTERVENTION; END-POINT DEFINITIONS; HIGH-RISK PATIENTS; INDUCED NEPHROPATHY; MEDIUM IODIXANOL; RENAL-FUNCTION; OSMOLAR; VASOCONSTRICTION; INTRAARTERIAL; METAANALYSIS;
D O I
10.1016/j.jjcc.2015.02.007
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Acute kidney injury (AKI) frequently occurs following transcatheter aortic valve implantation (TAVI) and has been related to a worse outcome. We investigated the importance of contrast medium composition, either iso-osmolar (IOCM) or low-osmolar (LOCM) and assessed predictors for AKI after TAVI. Methods and results: We assessed AKI in 203 TAVI patients treated mainly with trans-femoral implantation and analgosedation. A total of 100 patients received IOCM and 103 LOCM. AKI was defined according to the Valve Academic Research Consortium. Following TAVI, 39 patients (19.2%) developed AKI; 17.0% of the IOCM and 21.4% of the LOCM group (p = 0.43). The only independent predictor for AKI was baseline serum creatinine [odds ratio (OR) 0.26, 95% confidence interval (Cl) 0.01-0.64, p = 0.002]. Patients with advanced AKI (stages 2 and 3) post-TAVI had significantly higher mortality at 2 years (log rank p < 0.001), whereas patients with AKI stage 1 had a similar long-term outcome to non-AKI patients. Conclusions: Following TAVI, we observed no difference in the occurrence of AKI between IOCM and LOCM. Baseline creatinine was the only independent predictor of AKI, and patients who developed advanced AKI had significantly higher mortality at 2 years. (C) 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:514 / 519
页数:6
相关论文
共 34 条
[1]   Incidence, predictors and prognostic value of serious hemorrhagic complications following transcatheter aortic valve implantation [J].
Amabile, Nicolas ;
Azmoun, Alexandre ;
Ghostine, Said ;
Ramadan, Ramzi ;
Haddouche, Yacine ;
Raoux, Franois ;
Ngoc-Tram To ;
Troussier, Xavier ;
Nottin, Remi ;
Caussin, Christophe .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2013, 168 (01) :151-156
[2]   Who is the right patient for TAVI? [J].
Arai, Takahide ;
Lefeyre, Thierry .
JOURNAL OF CARDIOLOGY, 2014, 63 (3-4) :178-181
[3]   Risk of acute kidney injury in patients with severe aortic valve stenosis undergoing transcatheter valve replacement [J].
Aregger, Fabienne ;
Wenaweser, Peter ;
Hellige, Gerrit J. ;
Kadner, Alexander ;
Carrel, Thierry ;
Windecker, Stefan ;
Frey, Felix J. .
NEPHROLOGY DIALYSIS TRANSPLANTATION, 2009, 24 (07) :2175-2179
[4]   Nephrotoxic effects in high-risk patients undergoing angiography. [J].
Aspelin, P ;
Aubry, P ;
Fransson, S ;
Strasser, R ;
Willenbrock, R ;
Berg, KJ .
NEW ENGLAND JOURNAL OF MEDICINE, 2003, 348 (06) :491-499
[5]   Acute kidney injury following transcatheter aortic valve implantation: predictive factors, prognostic value, and comparison with surgical aortic value replacement [J].
Bagur, Rodrigo ;
Webb, John G. ;
Nietlispach, Fabian ;
Dumont, Eric ;
De Larochelliere, Robert ;
Doyle, Daniel ;
Masson, Jean-Bernard ;
Gutierrez, Marcos J. ;
Clavel, Marie-Annick ;
Bertrand, Olivier F. ;
Pibarot, Philippe ;
Rodes-Cabau, Josep .
EUROPEAN HEART JOURNAL, 2010, 31 (07) :865-874
[6]   Incidence and predictors of acute kidney injury after transcatheter aortic valve replacement [J].
Barbash, Israel M. ;
Ben-Dor, Itsik ;
Dvir, Danny ;
Maluenda, Gabriel ;
Xue, Zhenyi ;
Torguson, Rebecca ;
Satler, Lowell F. ;
Pichard, Augusto D. ;
Waksman, Ron .
AMERICAN HEART JOURNAL, 2012, 163 (06) :1031-1036
[7]   CONTRAST NEPHROPATHY IN PATIENTS WITH IMPAIRED RENAL-FUNCTION - HIGH VERSUS LOW OSMOLAR MEDIA [J].
BARRETT, BJ ;
PARFREY, PS ;
VAVASOUR, HM ;
MCDONALD, J ;
KENT, G ;
HEFFERTON, D ;
ODEA, F ;
STONE, E ;
REDDY, R ;
MCMANAMON, PJ .
KIDNEY INTERNATIONAL, 1992, 41 (05) :1274-1279
[8]   Incidence and predictors of acute kidney injury in patients undergoing transcatheter aortic valve implantation [J].
Elhmidi, Yacine ;
Bleiziffer, Sabine ;
Piazza, Nicolo ;
Hutter, Andrea ;
Opitz, Anke ;
Hettich, Ina ;
Kornek, Matthias ;
Ruge, Hendrik ;
Brockmann, Gernot ;
Mazzitelli, Domenico ;
Lange, Ruediger .
AMERICAN HEART JOURNAL, 2011, 161 (04) :735-739
[9]   The prognostic implications of further renal function deterioration within 48 h of interventional coronary procedures in patients with pre-existent chronic renal insufficiency [J].
Gruberg, L ;
Mintz, GS ;
Mehran, R ;
Dangas, G ;
Lansky, AJ ;
Kent, KM ;
Pichard, AD ;
Satler, LF ;
Leon, MB .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 36 (05) :1542-1548
[10]   Sex-Related Differences in Clinical Presentation and Outcome of Transcatheter Aortic Valve Implantation for Severe Aortic Stenosis [J].
Hayashida, Kentaro ;
Morice, Marie-Claude ;
Chevalier, Bernard ;
Hovasse, Thomas ;
Romano, Mauro ;
Garot, Philippe ;
Farge, Arnaud ;
Donzeau-Gouge, Patrick ;
Bouvier, Erik ;
Cormier, Bertrand ;
Lefevre, Thierry .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2012, 59 (06) :566-571