Vol 79, No 6 (2021)
Original article
Published online: 2021-04-06

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A simplified acute kidney injury predictor following transcatheter aortic valve implantation: ACEF score

Begum Uygur1, Omer Celik1, Ali Riza Demir1, Ahmet Anil Sahin1, Ahmet Guner1, Yalcin Avci1, Umit Bulut1, Omer Tasbulak1, Gokhan Demirci1, Fatih Uzun1, Ali Kemal Kalkan1, Mehmet Erturk1
Pubmed: 33871229
Kardiol Pol 2021;79(6):662-668.

Abstract

Background: Transcatheter aortic valve implantation (TAVI) is an effective, less invasive treatment alternative for symptomatic severe aortic stenosis (AS). Acute kidney injury (AKI) following TAVI is a common complication and is associated with worse outcomes. The age, creatinine, ejection fraction (ACEF) score is a simple scoring method, including only three parameters: age, creatinine, and ejection fraction (EF). The score was well established in predicting AKI after coronary interventions.
Aims: We aimed to evaluate whether this simple scoring method, ACEF, may predict a development of AKI in patients who underwent TAVI.
Methods: A total of 173 consecutive patients with symptomatic severe AS who underwent TAVI were included retrospectively. The primary endpoint of the study was the development of AKI. Study population was divided into two groups according to the presence of AKI. The ACEF score was calculated with the formula: age/EF + 1 (if baseline creatinine >2 mg/dl).
Results: Twenty-nine patients developed AKI. The median (interquartile range) ACEF score was 1.36 (1.20–1.58). The ACEF score was found to be an independent predictor of AKI (P <0.001). The ACEF score ≥1.36 predicted AKI development with a sensitivity of 96.6% and specificity of 58.8%. Moreover, hypertension, hemoglobin levels, contrast volume, and aortic valve area (AVA) were found to be independent predictors of AKI.
Conclusions: Our study revealed that the ACEF score was an independent predictor of AKI. A simple and objective score might be very useful in predicting AKI development in patients undergoing TAVI.




Polish Heart Journal (Kardiologia Polska)