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Article ; Online: Early acute kidney injury after transcatheter aortic valve implantation: predictive value of currently available risk scores.

Loizzi, Francesco / Burattini, Osvaldo / Cafaro, Alessandro / Spione, Francesco / Salemme, Luigi / Cioppa, Angelo / Fimiani, Luigi / Rimmaudo, Flavio / Pignatelli, Antonio / Palmitessa, Chiara / Mancini, Giandomenico / Pucciarelli, Armando / Bortone, Alessandro S / Contegiacomo, Gaetano / Tesorio, Tullio / Iacovelli, Fortunato

Hellenic journal of cardiology : HJC = Hellenike kardiologike epitheorese

2022 Volume 70, Page(s) 19–27

Abstract: Background: Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is ... implantation of self-expanding prostheses, as well as atrial fibrillation, low-osmolar contrast media ... population. This study aimed to evaluate the power of four different scores in predicting AKI after TAVI ...

Abstract	Background: Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is a frequent complication associated with adverse outcomes and mortality. Various scores have been developed to predict this complication in the coronary setting. However, none have ever been tested in a large TAVI population. This study aimed to evaluate the power of four different scores in predicting AKI after TAVI. Methods: Overall, 1535 consecutive TAVI patients from the observational multicentric "Magna Graecia" TAVI registry were included in the analysis. Of the study population, 235 (15.31%) developed AKI early. The Mehran, William Beaumont Hospital, CR Results: The patients who developed TAVI-related AKI had significantly higher absolute values of all risk scores than those who did not. The receiver-operating characteristic analysis also showed a significant correlation between these four scores and AKI, but without a significant difference among all of them (p value = 0.176). Nevertheless, based on their area under the curve values (≤0.604 for all), none had adequate diagnostic accuracy in predicting TAVI-related AKI. Importantly, multivariate analysis identified myocardial revascularization close to the TAVI procedure and implantation of self-expanding prostheses, as well as atrial fibrillation, low-osmolar contrast media administration, corrected contrast medium volume, and any transfusion (p value < 0.05 for all) as independent risk factors for AKI. Conclusions: Although high values of current AKI risk scores are significantly associated with the development of this complication, these are not sufficiently accurate. Further studies are needed so that a TAVI-dedicated AKI risk score may be created.
MeSH term(s)	Humans ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Aortic Valve/surgery ; Aortic Valve Stenosis/surgery ; Aortic Valve Stenosis/complications ; Retrospective Studies ; Risk Factors ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/methods
Language	English
Publishing date	2022-12-27
Publishing country	Netherlands
Document type	Journal Article ; Observational Study
ZDB-ID	2215027-4
ISSN	2241-5955 ; 1109-9666
ISSN (online)	2241-5955
ISSN	1109-9666
DOI	10.1016/j.hjc.2022.12.007
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Article: Neutrophil-to-lymphocyte ratio as a predictor of inflammatory response in patients with acute kidney injury after transcatheter aortic valve implantation.

Olasińska-Wiśniewska, Anna / Urbanowicz, Tomasz / Grodecki, Kajetan / Perek, Bartłomiej / Grygier, Marek / Michalak, Michał / Misterski, Marcin / Puślecki, Mateusz / Rodzki, Michał / Stelmark, Konrad / Lesiak, Maciej / Jemielity, Marek

Advances in clinical and experimental medicine : official organ Wroclaw Medical University

2022 Volume 31, Issue 9, Page(s) 937–945

Abstract: Background: Persistent inflammatory response after transcatheter aortic valve implantation (TAVI ... follow-up on-site examinations. Patients were retrospectively divided into acute kidney injury (AKI) and ... to measurement after 1 year with a statistically significant decline in the whole study population and non-AKI ...

Abstract	Background: Persistent inflammatory response after transcatheter aortic valve implantation (TAVI) is one of the possible causes of early and mid-term postprocedural adverse events. Objectives: To establish the predictive role of whole blood parameters on inflammatory response characteristics within a 1-year follow-up. Material and methods: The study group comprised 163 consecutive patients (52.1% females), mean age 78.6 (±6.6) years (± standard deviation (SD)) who underwent TAVI and completed 1-year follow-up on-site examinations. Patients were retrospectively divided into acute kidney injury (AKI) and non-AKI subgroups. Clinical and laboratory data were collected. In-hospital and follow-up outcomes were assessed. Results: The clinical and procedural details did not show significant differences between AKI and non-AKI groups. Neutrophil-to-lymphocyte ratio (NLR) decreased from baseline to measurement after 1 year with a statistically significant decline in the whole study population and non-AKI subgroup (both p = 0.005). The baseline NLR cutoff value of 4.2 for the non-AKI group ((area under the curve (AUC) = 0.718, p < 0.0001; sensitivity 46.27%, specificity 92.31%) and of 3.8 for the AKI group (AUC = 0.673, p = 0.0174; sensitivity 59.25%, specificity 84%) had prognostic properties for persistent NLR elevation. Conclusions: The NLR decreases after TAVI, and this phenomenon is more evident in patients without AKI. Furthermore, baseline NLR cutoff values may be considered predictors of persistence of inflammatory response.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/etiology ; Aged ; Aortic Valve Stenosis/surgery ; Female ; Follow-Up Studies ; Humans ; Lymphocytes ; Male ; Neutrophils ; Retrospective Studies ; Risk Factors ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome
Language	English
Publishing date	2022-07-03
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2270257-X
ISSN	1899-5276 ; 1230-025X
ISSN	1899-5276 ; 1230-025X
DOI	10.17219/acem/149229
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Zs.A 6489: Show issues

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Article ; Online: Predictors of Acute Kidney Injury After Transcatheter Aortic Valve Implantation (From National Inpatient Sample [2011-2018]).

Zahid, Salman / Ullah, Waqas / Khan, Muhammad U / Salama, Amr / Krupica, Troy / Khan, Muhammad Zia

The American journal of cardiology

2021 Volume 151, Page(s) 120–122

MeSH term(s)	Acute Kidney Injury/epidemiology ; Aged ; Aged, 80 and over ; Aortic Valve Disease/epidemiology ; Aortic Valve Disease/surgery ; Comorbidity ; Female ; Health Care Costs/statistics & numerical data ; Heart Failure/epidemiology ; Humans ; Length of Stay/economics ; Length of Stay/statistics & numerical data ; Liver Diseases/epidemiology ; Male ; Neoplasms/epidemiology ; Peripheral Vascular Diseases/epidemiology ; Postoperative Complications/economics ; Postoperative Complications/epidemiology ; Pulmonary Disease, Chronic Obstructive/epidemiology ; Renal Insufficiency, Chronic/epidemiology ; Risk Factors ; Transcatheter Aortic Valve Replacement ; Weight Loss
Language	English
Publishing date	2021-05-15
Publishing country	United States
Document type	Letter
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2021.04.003
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Article ; Online: Systemic inflammation and oxidative stress contribute to acute kidney injury after transcatheter aortic valve implantation.

Navaratnarajah, Arunraj / Bhan, Amit / Alcock, Emma / Dew, Tracy / Monaghan, Mark / Shah, Ajay M / Wendler, Olaf / MacCarthy, Philip / Dworakowski, Rafal

Cardiology journal

2020 Volume 29, Issue 5, Page(s) 824–835

Abstract: Background: Acute kidney injury (AKI) is a frequent complication of transcatheter aortic valve ... implantation (TAVI) and has been linked to preexisting comorbidities, peri-procedural hypotension, and systemic ... inflammation. The extent of systemic inflammation after TAVI is not fully understood. Our aim was ...

Abstract	Background: Acute kidney injury (AKI) is a frequent complication of transcatheter aortic valve implantation (TAVI) and has been linked to preexisting comorbidities, peri-procedural hypotension, and systemic inflammation. The extent of systemic inflammation after TAVI is not fully understood. Our aim was to characterize the inflammatory response after TAVI and evaluate its contribution to the mechanism of post-procedural AKI. Methods: One hundred and five consecutive patients undergoing TAVI at our institution were included. We analyzed the peri-procedural inflammatory and oxidative stress responses by measuring a range of biomarkers (including C-reactive protein [hsCRP], cytokine levels, and myeloperoxidase [MPO]), before TAVI and 6, 24, and 48 hours post-procedure. We correlated this with changes in renal function and patient and procedural characteristics. Results: We observed a significant increase in plasma levels of pro-inflammatory cytokines (hsCRP, interleukin 6, tumor necrosis factor alpha receptors) and markers of oxidative stress (MPO) after TAVI. The inflammatory response was significantly greater after transapical (TA) TAVI compared to transfemoral (TF). This was associated with a higher incidence of AKI in the TA cohort compared to TF (44% vs. 8%, respectively, p < 0.0001). The incidence of AKI was significantly lower when N-acetylcysteine (NAC) was given peri-procedurally (12% vs. 38%, p < 0.005). In multivariate analysis, only the TA approach and no use of NAC before the procedure were independent predictors of AKI. Conclusions: TAVI creates a significant post-procedural inflammatory response, more so with the TA approach. Mechanisms of AKI after TAVI are complex. Inflammatory response, hypoperfusion, and oxidative stress may all play a part and are potential therapeutic targets to reduce/prevent AKI.
MeSH term(s)	Acetylcysteine ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Aortic Valve ; Aortic Valve Stenosis/surgery ; Biomarkers ; C-Reactive Protein ; Humans ; Inflammation/etiology ; Interleukin-6 ; Oxidative Stress ; Peroxidase ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/methods ; Treatment Outcome ; Tumor Necrosis Factor-alpha
Chemical Substances	Biomarkers ; Interleukin-6 ; Tumor Necrosis Factor-alpha ; C-Reactive Protein (9007-41-4) ; Peroxidase (EC 1.11.1.7) ; Acetylcysteine (WYQ7N0BPYC)
Language	English
Publishing date	2020-12-21
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2488680-4
ISSN	1898-018X ; 1897-5593
ISSN (online)	1898-018X
ISSN	1897-5593
DOI	10.5603/CJ.a2020.0169
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Article ; Online: Late Adverse Cardiorenal Events of Catheter Procedure-Related Acute Kidney Injury After Transcatheter Aortic Valve Implantation.

The American journal of cardiology

2020 Volume 133, Page(s) 89–97

Abstract: ... following transcatheter aortic valve implantation (TAVI). A total of 2,518 patients who underwent TAVI ... Data regarding the longitudinal effect of catheter procedure-related acute kidney injury (AKI ... pacemaker implantation. The rates of HF readmission and future hemodialysis were significantly higher ...

Abstract	Data regarding the longitudinal effect of catheter procedure-related acute kidney injury (AKI) on clinical outcomes are limited. This study aimed to assess the late adverse cardiorenal events of AKI following transcatheter aortic valve implantation (TAVI). A total of 2,518 patients who underwent TAVI, excluding in-hospital deaths, were enrolled from the Japanese multicenter registry. The definition of AKI was determined using the Valve Academic Research Consortium-2 criteria. The incidence, predictors, major adverse renal and cardiac events (MARCE), and all-cause mortality of AKI were evaluated. MARCE included readmission for renal and heart failure (HF), hemodialysis requirement, and cardiovascular-renal death during the follow-up period. The incidence of AKI was 9.7% in the entire cohort. The significant predictive factors of AKI were men, diabetes mellitus, hypertension, chronic kidney disease, low albumin, overdose of contrast media, nontransfemoral approach, transfusion, vascular complications, and new pacemaker implantation. The rates of HF readmission and future hemodialysis were significantly higher in patients with AKI than in those without AKI (19.7% vs 9.0%, p <0.001, 3.3% vs 0.4%, p <0.001, respectively). Cox regression multivariate analysis showed that AKI occurrence was an independent predictive factor for the incremental risk of both MARCE and late mortality up to 4 years (hazard ratio [HR] 1.59, 95% confidence interval [CI] 0.75 to 1.20, p <0.001, HR 2.18, 95% CI 1.70 to 2.79; p <0.001, respectively). In conclusion, AKI occurrence was significantly associated with late adverse cardiorenal events after TAVI. Adequate clinical management can be expected to reduce AKI-related late phase cardiorenal damage even after successful TAVI.
MeSH term(s)	Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/therapy ; Aged ; Aged, 80 and over ; Aortic Valve Stenosis/complications ; Aortic Valve Stenosis/mortality ; Aortic Valve Stenosis/surgery ; Female ; Humans ; Incidence ; Japan ; Male ; Registries ; Renal Dialysis ; Risk Factors ; Survival Rate ; Time Factors ; Transcatheter Aortic Valve Replacement/adverse effects
Language	English
Publishing date	2020-07-24
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2020.07.041
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Article ; Online: The Negative Effect of Mean Perfusion Pressure on the Development of Acute Kidney Injury after Transcatheter Aortic Valve Implantation.

Gül, Ilker / Cerit, Levent / Senturk, Bihter / Zungur, Mustafa / Alkan, Mustafa Beyazıt / Kemal, Hatice / Cerit, Zeynep / Yaman, Belma / Usalp, Songul / Duygu, Hamza

Brazilian journal of cardiovascular surgery

2019 Volume 33, Issue 6, Page(s) 559–566

Abstract: ... of acute kidney injury (AKIN) after transcatheter aortic valve implantation (TAVI).: Methods: One hundred and forty ... and basal kidney functions, our study showed that lower mPP was strongly associated with development ... to the Valve Academic Research Consortium-2 recommendations. The patients were divided into two groups ...

Abstract	Objective: To evaluate the predictive value of mean perfusion pressure (mPP) in the development of acute kidney injury (AKIN) after transcatheter aortic valve implantation (TAVI). Methods: One hundred and forty seven consecutive patients with aortic stenosis (AS) were evaluated for this study and 133 of them were included. Mean arterial pressure (mAP) and central venous pressure (CVP) were used to calculate mPP before TAVI procedure (mPP = mAP-CVP). The occurrence of AKIN was evaluated with AKIN classification according to the Valve Academic Research Consortium-2 recommendations. The patients were divided into two groups according to the receiver operating characteristic (ROC) analysis of their mPP levels (high-risk group and low-risk group). Results: The AKIN prevalence was 22.6% in this study population. Baseline serum creatinine level, glomerular filtration rate, amount of contrast medium, and the level of mPP were determined as predictive factors for the development of AKIN. Conclusion: The occurrence of AKIN is associated with increased morbidity and mortality rates in patients with TAVI. In addition to the amount of contrast medium and basal kidney functions, our study showed that lower mPP was strongly associated with development of AKIN after TAVI.
MeSH term(s)	Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Aged ; Aortic Valve/surgery ; Aortic Valve Stenosis/surgery ; Blood Pressure ; Contrast Media ; Cyprus/epidemiology ; Female ; Heart Valve Prosthesis ; Heart Valve Prosthesis Implantation/adverse effects ; Heart Valve Prosthesis Implantation/methods ; Humans ; Male ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; ROC Curve ; Risk Factors ; Survival Rate ; Transcatheter Aortic Valve Replacement/adverse effects ; Transcatheter Aortic Valve Replacement/methods
Chemical Substances	Contrast Media
Language	English
Publishing date	2019-01-17
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	2031026-2
ISSN	1678-9741 ; 0102-7638
ISSN (online)	1678-9741
ISSN	0102-7638
DOI	10.21470/1678-9741-2018-0137
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Article ; Online: Impact of contrast medium osmolality on the risk of acute kidney injury after transcatheter aortic valve implantation: insights from the Magna Graecia TAVI registry.

Iacovelli, Fortunato / Pignatelli, Antonio / Cafaro, Alessandro / Stabile, Eugenio / Salemme, Luigi / Cioppa, Angelo / Pucciarelli, Armando / Spione, Francesco / Loizzi, Francesco / De Cillis, Emanuela / Pestrichella, Vincenzo / Bortone, Alessandro Santo / Tesorio, Tullio / Contegiacomo, Gaetano

International journal of cardiology

2020 Volume 329, Page(s) 56–62

Abstract: Background: Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is ... from chronic kidney disease (CKD).: Results: The incidence of AKI was significantly lower with IOCM (9.73%) than with LOCM ...

Abstract	Background: Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is frequent and associated with adverse outcomes and mortality; to date, in such setting of patients there is no consistent evidence that either low-osmolar contrast media (LOCM) or iso-osmolar contrast medium (IOCM) are superior to the other in terms of renal safety. Methods: 697 consecutive patients not in hemodialysis treatment who underwent TAVI (327 males, mean age 81.01 ± 5.75 years, mean european system for cardiac operative risk evaluation II 6.17 ± 0.23%) were enrolled. According to osmolality of the different iodinated CM, the population was divided in 2 groups: IOCM (n = 370) and LOCM group (n = 327). Preoperatively, 40.54% of patients in IOCM vs 39.14% in LOCM group (p = 0.765) suffered from chronic kidney disease (CKD). Results: The incidence of AKI was significantly lower with IOCM (9.73%) than with LOCM (15.90%; p = 0.02), and such significant difference (p < 0.001) in postprocedural change of renal function parameters persisted at discharge too. The incidence of AKI was also significantly lower with IOCM in younger patients, without diabetes, anemia, coronary artery disease history, CKD, chronic or persistent atrial fibrillation, left ventricular ejection fraction ≤35%, and in patients with low operative mortality risk scores, receiving lower amounts of dye (p < 0.05 for all). Importantly, multivariate analysis identified LOCM administration as an independent risk factor for both AKI (p = 0.006) and 1-year mortality (p = 0.001). Conclusions: The use of IOCM have a favorable impact on renal function with respect to LOCM, but it should be considered especially for TAVI patients at lower AKI risk.
MeSH term(s)	Acute Kidney Injury/chemically induced ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/epidemiology ; Aged ; Aged, 80 and over ; Aortic Valve/surgery ; Aortic Valve Stenosis/diagnostic imaging ; Aortic Valve Stenosis/surgery ; Contrast Media/adverse effects ; Humans ; Male ; Osmolar Concentration ; Registries ; Risk Factors ; Stroke Volume ; Transcatheter Aortic Valve Replacement/adverse effects ; Treatment Outcome ; Ventricular Function, Left
Chemical Substances	Contrast Media
Language	English
Publishing date	2020-12-25
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	779519-1
ISSN	1874-1754 ; 0167-5273
ISSN (online)	1874-1754
ISSN	0167-5273
DOI	10.1016/j.ijcard.2020.12.049
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Article: The incidence, predictors, and prognosis of acute kidney injury after transcatheter aortic valve implantation .

Attard, Stephanie / Buttigieg, Jesmar / Galea, Stephanie / Mintoff, Malcolm / Farrugia, Emanuel / Cassar, Andrew

Clinical nephrology

2018 Volume 90, Issue 6, Page(s) 373–379

Abstract: Introduction and aims: Transcatheter aortic valve implantation (TAVI) is an alternative procedure ... TAVI can still result in serious complications including acute kidney injury (AKI).: Materials and ... 5.8% stage 2, and 3.9% stage 3. These patients had higher incidence of chronic kidney disease (CKD ...

Abstract	Introduction and aims: Transcatheter aortic valve implantation (TAVI) is an alternative procedure for patients with symptomatic aortic stenosis unfit for open heart surgery. Notwithstanding the safer profile, TAVI can still result in serious complications including acute kidney injury (AKI). Materials and methods: We conducted a single-center retrospective study to investigate the incidence of AKI following TAVI, identify any predictors, and assess the impact on patient survival. Results: A total of 104 patients underwent TAVI at a mean age of 76.7 ± 7.2 years. AKI occurred in 35.9% of patients; 26.2% stage 1, 5.8% stage 2, and 3.9% stage 3. These patients had higher incidence of chronic kidney disease (CKD) (37.8 vs. 18.2%; p = 0.035), higher median EuroSCORE-II (4.2, IQR: 5.7 vs. 2.7, IQR: 3.6; p = 0.019), longer hospital stay (6 days, IQR: 7 vs. 5 days, IQR: 3; p = 0.016), and higher all-cause mortality (35.1 vs. 12.1%, p = 0.01) compared to patients without AKI. None of the patient mortality was directly related to the TAVI-AKI event. EuroSCORE-II (OR: 1.19, CI: 1.05 - 1.37, p = 0.009) and CKD (OR: 2.74, CI: 1.10 - 6.82, p = 0.03) were established as independent predictors for AKI. Cumulative survival was lower in patients with AKI (log-rank; χ Conclusion: More than a third of patients undergoing TAVI developed AKI. These had significantly higher incidence of CKD, higher EuroSCORE-II, higher all-cause mortality, and longer hospital stay. Finally, EuroSCORE-II and CKD were established as independent predictors for AKI and can therefore be used for risk stratification. .
MeSH term(s)	Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Aged ; Aged, 80 and over ; Aortic Valve Stenosis/surgery ; Female ; Humans ; Incidence ; Length of Stay ; Male ; Prognosis ; Renal Insufficiency, Chronic/complications ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Survival Rate ; Transcatheter Aortic Valve Replacement/adverse effects
Language	English
Publishing date	2018-10-15
Publishing country	Germany
Document type	Journal Article
ZDB-ID	185101-9
ISSN	0301-0430
ISSN	0301-0430
DOI	10.5414/CN109544
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Zs.A 873: Show issues

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Article: Novel renal biomarker evaluation for early detection of acute kidney injury after transcatheter aortic valve implantation.

Arsalan, Mani / Ungchusri, Ethan / Farkas, Robert / Johnson, Melissa / Kim, Rebeca J / Filardo, Giovanni / Pollock, Benjamin D / Szerlip, Molly / Mack, Michael J / Holper, Elizabeth M

Proceedings (Baylor University. Medical Center)

2018 Volume 31, Issue 2, Page(s) 171–176

Abstract: Acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI) is associated ... with increased morbidity and mortality. The biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney ... injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are predictive of AKI after cardiac surgery ...

Abstract	Acute kidney injury (AKI) following transcatheter aortic valve implantation (TAVI) is associated with increased morbidity and mortality. The biomarkers neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) are predictive of AKI after cardiac surgery, but there is little data regarding these biomarkers after TAVI. We evaluated the associations between NGAL, KIM-1, and IL-18 levels and the incidence and severity of AKI and changes in serum creatinine after TAVI. This was a prospective pilot study of 66 TAVI cases. Urinary biomarkers were measured at baseline and at 2, 4, and 12 hours after TAVI. Demographics, procedural features, and renal function until discharge were compared between patients with and without subsequent AKI. Seventeen patients (25.8%) developed AKI postoperatively (stage 1, n = 14; stage 2, n = 1; stage 3, n = 2). There were no significant differences in unadjusted mean NGAL, KIM-1, and IL-18 levels between patients with and without AKI at 2, 4, and 12 hours following surgery. After adjusting for the Society of Thoracic Surgeons risk of mortality, this study of three urinary biomarkers showed no association with AKI or creatinine after TAVI. Ongoing efforts to predict and modify the risk of AKI after TAVI remain challenging.
Language	English
Publishing date	2018-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2703932-8
ISSN	1525-3252 ; 0899-8280
ISSN (online)	1525-3252
ISSN	0899-8280
DOI	10.1080/08998280.2017.1416235
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Zs.A 6987: Show issues

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Article ; Online: Clinical effects of acute kidney injury after transcatheter aortic valve implantation: a systematic review and meta-analysis.

Ma, Min / Gao, Wei-Dong / Gu, Yun-Fei / Wang, Yu-Shu / Zhu, Ye / He, Yong

Internal and emergency medicine

2018 Volume 14, Issue 1, Page(s) 161–175

Abstract: ... may significantly worsen the prognosis of a transcatheter aortic valve implantation (TAVI). The purpose ... Several observational studies have shown that postoperative acute kidney injury (AKI ... cerebrovascular accidents (OR 1.92, 95% CI 1.23-2.98, P = 0.004). Acute kidney injury following TAVI is associated ...

Abstract	Several observational studies have shown that postoperative acute kidney injury (AKI) may significantly worsen the prognosis of a transcatheter aortic valve implantation (TAVI). The purpose of this systematic review and meta-analysis is to evaluate the recent evidence on the impact of AKI on clinical outcomes following TAVI. A comprehensive search in PubMed, Embase and the Cochrane Library was performed for relevant studies by two independent investigators. We pooled the odds ratio (OR) from individual studies, and performed heterogeneity, quality assessment and publication bias analysis. Forty-three eligible studies comprising 544,112 patients were included. Postoperative AKI not only significantly increased the risk for short-term and long-term all-cause mortality (OR 6.25, 95% CI 5.72-6.83, P < 0.00001; OR 3.49, 95% CI 2.78-4.40, P < 0.00001, respectively), but also increased the risk for early myocardial infarction (OR 3.98, 95% CI 1.90-8.31, P = 0.0002), major and life-threatening bleeding (OR 1.51, 95% CI 1.12-2.03, P = 0.007; OR 2.35, 95% CI 1.80-3.06, P < 0.00001, respectively), major vascular complications (OR 1.69, 95% CI 1.30-2.18, P < 0.0001), need for blood transfusion (OR 2.15, 95% CI 1.89-2.46, P < 0.00001) renal replacement therapy (OR 22.36, 95% CI 11.88-42.12, P = 0.0002) and cerebrovascular accidents (OR 1.92, 95% CI 1.23-2.98, P = 0.004). Acute kidney injury following TAVI is associated with increased postoperative mortality and morbidity. Future efforts are required to determine whether early prevention of post-procedural AKI after TAVI impacts upon clinical outcomes.
MeSH term(s)	Humans ; Acute Kidney Injury/epidemiology ; Acute Kidney Injury/etiology ; Acute Kidney Injury/mortality ; Hemorrhage/epidemiology ; Hemorrhage/mortality ; Myocardial Infarction/epidemiology ; Myocardial Infarction/mortality ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/mortality ; Prognosis ; Risk Factors ; Transcatheter Aortic Valve Replacement/adverse effects ; Observational Studies as Topic
Language	English
Publishing date	2018-09-01
Publishing country	Italy
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2454173-4
ISSN	1970-9366 ; 1828-0447
ISSN (online)	1970-9366
ISSN	1828-0447
DOI	10.1007/s11739-018-1935-6
Database	MEDical Literature Analysis and Retrieval System OnLINE

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