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RENAL FUNCTION AS PREDICTOR OF MORTALITY IN PATIENTS AFTER PERCUTANEOUS TRANSCATHETER AORTIC VALVE IMPLANTATION
E1331 JACC April 5, 2011 Volume 57, Issue 14
VALVULAR HEART DISEASE RENAL FUNCTION AS PREDICTOR OF MORTALITY IN PATIENTS AFTER PERCUTANEOUS TRANSCATHETER AORTIC VALVE IMPLANTATION ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Sunday, April 03, 2011, 3:30 p.m.-4:45 p.m.
Session Title: Aortic Valve Disease and its Treatment Abstract Category: 19. Valvular Disease Session-Poster Board Number: 1049-55 Authors: Jan-Malte Sinning, Alexander Ghanem, Hannah Steinhäuser, Viktoria Adenauer, Christoph Hammerstingl, Georg Nickenig, Nikos Werner, Medizinische Klinik II, Universitätsklinikum Bonn, Bonn, Germany Background: Evidence is growing that renal function is a major predictor of mortality in patients after TAVI. The aim of this study is to determine the influence of peri-procedural acute kidney injury (AKI) on prognosis after transcatheter aortic valve implantation (TAVI). Methods: TAVI was performed with the 18F-CoreValve™ prosthesis via transfemoral access in 92 consecutive patients with a mean age of 80.7±6.3 years (STS mortality score 9.4±7.1%, logistic EuroSCORE 30.0±17.5%). 6 patients on chronic dialysis were excluded from this analysis. Results: Overall procedural success rate was 98% with one periprocedural death. 30-day mortality was 8.7%, 1-year mortality was 28.3%. AKI occurred in 23/86 patients: 15 patients (58%) with AKI died during follow-up. The incidence of AKI was related to peripheral arterial disease (61 vs. 39%; P=0.04), the occurrence of a systemic inflammatory response syndrome (65 vs. 21%, P<0.001), and to post-procedural, paraprosthetic regurgitation ≥2+ (35 vs. 8%; P=0.02). Impaired renal function at baseline reflected by serum creatinine ≥1.58 mg/dL (HR 2.3, 95% CI: 1.1-5.3; P=0.04) and the occurrence of AKI (HR 6.6, 95% CI: 2.9-15.2, P<0.001) which was not related to the amount of contrast dye were strong predictors of 1-year mortality after TAVI. Conlusions: The occurrence of peri-procedural AKI - independent whether renal function returns to baseline or not - is the strongest independent predictor of 30-day and 1-year mortality after TAVI.
VALVULAR HEART DISEASE RENAL FUNCTION AS PREDICTOR OF MORTALITY IN PATIENTS AFTER PERCUTANEOUS TRANSCATHETER AORTIC VALVE IMPLANTATION ACC Poster Contributions Ernest N. Morial Convention Center, Hall F Sunday, April 03, 2011, 3:30 p.m.-4:45 p.m.
Session Title: Aortic Valve Disease and its Treatment Abstract Category: 19. Valvular Disease Session-Poster Board Number: 1049-55 Authors: Jan-Malte Sinning, Alexander Ghanem, Hannah Steinhäuser, Viktoria Adenauer, Christoph Hammerstingl, Georg Nickenig, Nikos Werner, Medizinische Klinik II, Universitätsklinikum Bonn, Bonn, Germany Background: Evidence is growing that renal function is a major predictor of mortality in patients after TAVI. The aim of this study is to determine the influence of peri-procedural acute kidney injury (AKI) on prognosis after transcatheter aortic valve implantation (TAVI). Methods: TAVI was performed with the 18F-CoreValve™ prosthesis via transfemoral access in 92 consecutive patients with a mean age of 80.7±6.3 years (STS mortality score 9.4±7.1%, logistic EuroSCORE 30.0±17.5%). 6 patients on chronic dialysis were excluded from this analysis. Results: Overall procedural success rate was 98% with one periprocedural death. 30-day mortality was 8.7%, 1-year mortality was 28.3%. AKI occurred in 23/86 patients: 15 patients (58%) with AKI died during follow-up. The incidence of AKI was related to peripheral arterial disease (61 vs. 39%; P=0.04), the occurrence of a systemic inflammatory response syndrome (65 vs. 21%, P<0.001), and to post-procedural, paraprosthetic regurgitation ≥2+ (35 vs. 8%; P=0.02). Impaired renal function at baseline reflected by serum creatinine ≥1.58 mg/dL (HR 2.3, 95% CI: 1.1-5.3; P=0.04) and the occurrence of AKI (HR 6.6, 95% CI: 2.9-15.2, P<0.001) which was not related to the amount of contrast dye were strong predictors of 1-year mortality after TAVI. Conlusions: The occurrence of peri-procedural AKI - independent whether renal function returns to baseline or not - is the strongest independent predictor of 30-day and 1-year mortality after TAVI.