Incidence and impact of renal dysfunction on clinical outcomes after transcatheter aortic valve implantation

Franzone, Anna; Stortecky, Stefan; Pilgrim, Thomas; Asami, Masahiko; Lanz, Jonas; Heg, Dik; Langhammer, Bettina; Piccolo, Raffaele; Lee, Joe K.T.; Praz, Fabien; Räber, Lorenz; Valgimigli, Marco; Roost, Eva; Windecker, Stephan

doi:10.1016/j.ijcard.2017.09.201

Cited by 12 publications

(18 citation statements)

References 33 publications

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“…An alternative non femoral approach was more frequently used in patients who developed AKI, probably related to peripheral arterial disease and consequent unfavorable anatomy. After adjustment for clinical confounding variables in a multivariate analysis, general anesthesia and contrast media amount were found independent predictors of AKI, in conformity with previous published data 1 . Iodine contrast media is one of the common nephrotoxic agents.…”

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confidence: 89%

“…1 Reports from published data documented concomitant renal dysfunction in a great proportion of TAVR recipients: chronic kidney disease (CKD) and postprocedural acute kidney injury (AKI) are two wellknown predictors of increased mortality. 1 In this issue of Catheterization and Cardiovascular Interventions, Adamo et al provide interesting insights into the minefield of renal dysfunction in TAVR patients. The study was aimed to explore the complex interaction between severe CKD and postprocedural AKI to Another relevant section of the manuscript is focused on the predictors of AKI.…”

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confidence: 99%

“…Worldwide use of TAVR is accelerating: percutaneous aortic valve implantation has become the alternative of choice in patients with high and intermediate risk for surgical replacement. Commonly TAVR patients have several and complex comorbidities 1 . Reports from published data documented concomitant renal dysfunction in a great proportion of TAVR recipients: chronic kidney disease (CKD) and postprocedural acute kidney injury (AKI) are two well‐known predictors of increased mortality 1 …”

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confidence: 99%

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Renal function and outcomes in TAVR patients: Complexity in real world

Musumeci

Colopi

2020

Cathet Cardio Intervent

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confidence: 99%

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Renal function and outcomes in TAVR patients: Complexity in real world

Musumeci

Colopi

2020

Cathet Cardio Intervent

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“…Although the trend was not significant after adjustment for confounders, low occurrence of post-procedural renal dysfunction may have a positive impact on clinical outcomes, given the well-known association of advanced acute renal injury with higher risk of mortality and re-hospitalization. 23,24 Similarly, the observed significant reduction of early life-threatening or major bleeding events may have contributed to ameliorate 30-day survival over time.…”

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confidence: 99%

Temporal trends in adoption and outcomes of transcatheter aortic valve implantation: a SwissTAVI Registry analysis

Stortecky

Franzone

Heg

et al. 2018

European Heart Journal - Quality of Care and Clinical Outcomes

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Aims To describe temporal trends in adoption and performance of transcatheter aortic valve implantation (TAVI) in Switzerland over a period of 5 years. Methods and results Between 2011 and 2015, a total of 3493 patients were consecutively included in the SwissTAVI Registry (NCT01368250) and analysed for the purpose of this study. The primary outcome measure was all-cause mortality at 1 year after TAVI. Over the 5-year period, a six-fold increase in the number of procedures was observed, whereas the baseline surgical risk estimated by the Society of Thoracic Surgeon (STS) score declined (from 6.8 ± 4.4% to 4.6 ± 3.6, P < 0.001). Overall, 1-year mortality amounted to 12.8%; mortality was highest in the first annual cohorts (14.6%, 14.8%, and 15.9% in 2011, 2012, and 2013, respectively) and decreased to 13.4% in 2014 and 9.7% in 2015. While rates of cerebrovascular events, peri-procedural myocardial infarction, moderate/severe paravalvular regurgitation, and Stage 3 acute kidney injury did not significantly change over time, a significant reduction in life threatening or major bleeding was noted at 30-day follow-up during the latest compared with earlier years of recruitment. Conclusion This long-term recruitment analysis of a national TAVI registry showed rapid adoption paralleled by a progressive decrease of patients’ baseline risk profile. Early and late survival significantly improved over time as did the rate of life threatening or major bleeding.

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“…It has been observed that circulating galectin-3 is increased in patients with renal dysfunction [ 30 ]. Moreover, impaired renal function has been related to poor prognosis after TAVR [ 31 , 32 ]. Therefore, it could be inferred that renal dysfunction may confound the association between increased circulating galectin-3 and poor survival after TAVR.…”

Section: Discussionmentioning

confidence: 99%

Preprocedural circulating galectin-3 and the risk of mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis

et al. 2020

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Background: Galectin-3 may predict mortality for patients with aortic stenosis (AS) after transcatheter aortic valve replacement (TAVR). However, the results were inconsistent. We aimed to evaluate the association between baseline galectin and mortality after TAVR in a meta-analysis. Methods: Related follow-up studies were obtained by systematic search of PubMed, Cochrane’s Library, and Embase databases. Both the fixed and the random-effect models were used for the meta-analysis. Subgroup analyses were performed to evaluate the influences of study characteristics on the outcome. Results: Five prospective cohort studies with 854 patients were included, with a follow-up period between 1-1.9 years. Patients with higher baseline circulating galectin-3 had an increased risk of all-cause mortality after TAVR (random-effect model: risk ratio [RR]: 1.63, 95% confidence interval [CI]: 1.19 to 2.23, P = 0.002; fixed effect model: RR: 1.62, 95% CI: 1.19 to 2.20, P = 0.002; I2 = 4%). Adjustment of estimated glomerular filtration rate (RR: 1.73, P = 0.02) or B type natriuretic peptide or N-terminal pro B type natriuretic peptide (RR: 1.83, P = 0.02) did not significantly affect the result. A trend of stronger association between higher baseline circulating galectin-3 and increased risk of all-cause mortality after TAVR was observed in studies with an enzyme-linked fluorescent assay (RR: 3.04, P = 0.003) compared to those with an enzyme linked immunosorbent assay (RR: 1.42, P = 0.04; P for subgroup difference = 0.06). Conclusions: Higher circulating galectin-3 before the procedure may predict all-cause mortality of AS patients after TAVR.

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Incidence and impact of renal dysfunction on clinical outcomes after transcatheter aortic valve implantation

Cited by 12 publications

References 33 publications

Renal function and outcomes in TAVR patients: Complexity in real world

Renal function and outcomes in TAVR patients: Complexity in real world

Temporal trends in adoption and outcomes of transcatheter aortic valve implantation: a SwissTAVI Registry analysis

Preprocedural circulating galectin-3 and the risk of mortality after transcatheter aortic valve replacement: a systematic review and meta-analysis

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