Impact of post-procedural hyperglycemia on acute kidney injury after transcatheter aortic valve implantation

Giannini, Francesco; Latib, Azeem; Jabbour, Richard J.; Ruparelia, Neil; Aurelio, Andrea; Ancona, Marco; Figini, Filippo; Mangieri, Antonio; Regazzoli, Damiano; Tanaka, Akihito; Montalto, Claudio; Azzalini, Lorenzo; Monaco, Fabrizio; Agricola, Eustachio; Chieffo, Alaide; Montorfano, Matteo; Alfieri, Ottavio; Colombo, Antonio

doi:10.1016/j.ijcard.2016.07.029

Cited by 13 publications

(14 citation statements)

References 35 publications

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“…Hyperglycemia is another novel risk factor, which has been associated with increased AKI development [65][66][67][68][69][70]. However, the target level of glucose to decrease AKI risk has not been determined.…”

Section: Aki Definition and Biomarkersmentioning

confidence: 99%

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Artificial Intelligence in Acute Kidney Injury Risk Prediction

Gameiro

Branco

Lopes

2020

JCM

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Acute kidney injury (AKI) is a frequent complication in hospitalized patients, which is associated with worse short and long-term outcomes. It is crucial to develop methods to identify patients at risk for AKI and to diagnose subclinical AKI in order to improve patient outcomes. The advances in clinical informatics and the increasing availability of electronic medical records have allowed for the development of artificial intelligence predictive models of risk estimation in AKI. In this review, we discussed the progress of AKI risk prediction from risk scores to electronic alerts to machine learning methods.

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Section: Aki Definition and Biomarkersmentioning

confidence: 99%

“…However, the target level of glucose to decrease AKI risk has not been determined. The exact mechanism is still uncertain, but hyperglycemia might contribute to AKI through stimulation of oxidative stress, vasoconstriction and reduced renal oxygen delivery, and volume depletion due to osmotic diuresis [68,70].…”

Section: Aki Definition and Biomarkersmentioning

confidence: 99%

Artificial Intelligence in Acute Kidney Injury Risk Prediction

Gameiro

Branco

Lopes

2020

JCM

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“…Among patients with AMI undergoing coronary angiography, preprocedural glucose was an independent predictor of CI-AKI in patients without known diabetes, but not in patients with diabetes [84]. Another study targeting patients who underwent transcatheter aortic valve implantation (TAVI) concluded that those with postprocedural hyperglycemia had a twofold higher occurrence of AKI, regardless of the presence of DM and CKD [85]. …”

Section: Risk Factorsmentioning

confidence: 99%

“…Suggested mechanisms for a causal relationship between hyperglycemia and AKI included the following [85, 90]. Hyperglycemia is accompanied by stress responses, mediated by the release of cortisol and catecholamines.…”

Section: Risk Factorsmentioning

confidence: 99%

Are There Modifiable Risk Factors to Improve AKI?

Nie

Zhang

et al. 2017

BioMed Research International

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Acute kidney injury (AKI) is a common critical syndrome, with high morbidity and mortality. Patients with AKI typically have an adverse prognosis, from incident chronic kidney disease (CKD), progression to end-stage renal disease (ESRD), subsequent cardiovascular disease, and ultimately death. However, there is currently no effective therapy for AKI. Early detection of risk factors for AKI may offer a good approach to prevention or early intervention. Traditional risk factors include extreme age, many common comorbid diseases, such as preexisting CKD, some specific exposures, such as sepsis, and exposure to some nephrotoxic agents. Recently, several novel risk factors for AKI, such as hyperuricemia, hypoalbuminemia, obesity, anemia, and hyperglycemia, have been identified. The underlying mechanisms between these nontraditional risk factors and AKI and whether their correction can reduce AKI occurrence remain to be clarified. This review describes the current epidemiology of AKI, summarizes its outcome, outlines the traditional risk profile, and finally highlights some recently identified novel risk factors.

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“…Although TAVI is not considered as a major surgical procedure, high post-procedure morbidity and mortality have been reported, mainly explained by the severe comorbidities presented by these patients [12, 13]. Although patient outcome after TAVI was not found to be different in diabetic and non-diabetic patients [14–16], Giannini et al [17]. have recently suggested that post-procedural acute hyperglycemia increased the risk of acute kidney injury and was associated with higher mortality after TAVI.…”

Section: Introductionmentioning

confidence: 99%

Impact of post-procedural glycemic variability on cardiovascular morbidity and mortality after transcatheter aortic valve implantation: a post hoc cohort analysis

Besch

Pili-Floury

Morel

et al. 2019

Cardiovasc Diabetol

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BackgroundGlycemic variability is associated with worse outcomes after cardiac surgery, but the prognosis value of early glycemic variability after transcatheter aortic valve implantation is not known. This study was therefore designed to analyze the prognosis significance of post-procedural glycemic variability within 30 days after transcatheter aortic valve implantation.MethodsA post hoc analysis of patients from our center included in the FRANCE and FRANCE-2 registries was conducted. Post-procedural glycemic variability was assessed by calculating the mean daily δ blood glucose during the first 2 days after transcatheter aortic valve implantation. Major complications within 30 days were death, stroke, myocardial infarction, acute heart failure, and life-threatening cardiac arrhythmias.ResultsWe analyzed 160 patients (age (median [interquartile] = 84 [80–88] years; diabetes mellitus (n) = 41 (26%) patients; logistic Euroscore = 20 [12–32]). The median value of mean daily δ blood glucose was 4.3 mmol l−1. The rate of major complications within 30 days after procedure among patients with the lowest quartile of glycemic variability was 12%, increasing from 12 to 26%, and 39% in the second, third, and fourth quartiles, respectively. In multivariate analysis, glycemic variability was independently associated with an increased risk of major complications within 30 days after the procedure (odds ratio [95% CI] = 1.83 [1.19–2.83]; p = 0.006).ConclusionsThis study showed that post-procedural glycemic variability was associated with an increased risk of major complications within 30 days after transcatheter aortic valve implantation.Trial registration Clinical trial registration number https://www.clinicaltrials.gov/; identifier: NCT02726958; date: April 4th, 2016

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Impact of post-procedural hyperglycemia on acute kidney injury after transcatheter aortic valve implantation

Cited by 13 publications

References 35 publications

Artificial Intelligence in Acute Kidney Injury Risk Prediction

Artificial Intelligence in Acute Kidney Injury Risk Prediction

Are There Modifiable Risk Factors to Improve AKI?

Impact of post-procedural glycemic variability on cardiovascular morbidity and mortality after transcatheter aortic valve implantation: a post hoc cohort analysis

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