TY - JOUR
T1 - Frequency, Determinants, and Prognostic Effects of Acute Kidney Injury and Red Blood Cell Transfusion in Patients Undergoing Transcatheter Aortic Valve Implantation
AU - Nuis, Rutger-jan
AU - van Mieghem, Nicolas
AU - Tzikas, Apostolos
AU - Piazza, Nick
AU - Otten, AM (Amber)
AU - Cheng, Jin Ming
AU - van Domburg, Ron
AU - Betjes, M
AU - Serruys, PWJC (Patrick)
AU - de Jaegere, Peter
PY - 2011
Y1 - 2011
N2 - Objectives: To determine the frequency and independent predictors of acute kidney injury (AKI) in addition to the prognostic implications of both AKI and periprocedural red blood cell (RBC) transfusions on 30 day and cumulative late mortality in patients undergoing transcatheter aortic valve implantation (TAVI). Background: RBC transfusions have been reported to predict AKI following TAVI. Data on the prognostic implications of both factors, however, are lacking. Methods: 126 consecutive patients underwent TAVI with the Medtronic Core Valve Revalving System. AKI was defined according to the valve academic research consortium definitions as an absolute increase in serum creatinine >= 0.3 mg dL(-1) (>= 26.4 mu mol L(-1)) or a percentage increase >= 50% within 72 hr following TAVI. Results: Five patients on chronic haemodialysis and three intraprocedural deaths were excluded, leading to a final study population of 118 patients. AKI occurred in 19% of the patients necessitating temporary haemodialysis in 2%. Independent predictors of AKI included: previous myocardial infarction (OR: 5.72; 95% CI: 1.64-19.94), periprocedural (<24 hr) RBC transfusions (OR: 1.29; 95% CI: 1.01-1.70), postprocedural (<72 hr) leucocyte count (OR: 1.18; 95% CI: 1.02-1.37), and logistic EuroSCORE (OR: 1.08; 95% CI: 1.01-1.14). In patients with AKI, 30-day mortality was 23% and cumulative late mortality (median: 13 months) was 55%. AKI (OR: 5.47; 95% CI: 1.23-24.21) and postprocedural leucocyte count (OR: 1.20; 95% CI: 1.03-1.38) were independent predictors of 30-day mortality while AKI (HR: 2.79; 95% CI: 1.36-5.71) was the only independent predictor of late mortality. Conclusions: AKI following TAVI occurred in 19% of the patients. RBC transfusion was found to be an independent predictor of AKI, which in turn predicted both 30-day and cumulative late mortality. (C) 2011 Wiley-Liss, Inc.
AB - Objectives: To determine the frequency and independent predictors of acute kidney injury (AKI) in addition to the prognostic implications of both AKI and periprocedural red blood cell (RBC) transfusions on 30 day and cumulative late mortality in patients undergoing transcatheter aortic valve implantation (TAVI). Background: RBC transfusions have been reported to predict AKI following TAVI. Data on the prognostic implications of both factors, however, are lacking. Methods: 126 consecutive patients underwent TAVI with the Medtronic Core Valve Revalving System. AKI was defined according to the valve academic research consortium definitions as an absolute increase in serum creatinine >= 0.3 mg dL(-1) (>= 26.4 mu mol L(-1)) or a percentage increase >= 50% within 72 hr following TAVI. Results: Five patients on chronic haemodialysis and three intraprocedural deaths were excluded, leading to a final study population of 118 patients. AKI occurred in 19% of the patients necessitating temporary haemodialysis in 2%. Independent predictors of AKI included: previous myocardial infarction (OR: 5.72; 95% CI: 1.64-19.94), periprocedural (<24 hr) RBC transfusions (OR: 1.29; 95% CI: 1.01-1.70), postprocedural (<72 hr) leucocyte count (OR: 1.18; 95% CI: 1.02-1.37), and logistic EuroSCORE (OR: 1.08; 95% CI: 1.01-1.14). In patients with AKI, 30-day mortality was 23% and cumulative late mortality (median: 13 months) was 55%. AKI (OR: 5.47; 95% CI: 1.23-24.21) and postprocedural leucocyte count (OR: 1.20; 95% CI: 1.03-1.38) were independent predictors of 30-day mortality while AKI (HR: 2.79; 95% CI: 1.36-5.71) was the only independent predictor of late mortality. Conclusions: AKI following TAVI occurred in 19% of the patients. RBC transfusion was found to be an independent predictor of AKI, which in turn predicted both 30-day and cumulative late mortality. (C) 2011 Wiley-Liss, Inc.
U2 - 10.1002/ccd.22874
DO - 10.1002/ccd.22874
M3 - Article
C2 - 21061244
SN - 1522-1946
VL - 77
SP - 881
EP - 889
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 6
ER -