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Published online: 2022-08-03
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Acute kidney injury as the most important predictor of poor prognosis after interventional treatment for aortic stenosis

Anita Korczak1, Robert Morawiec1, Michał Stegienta1, Aleksandra Ryk1, Andrzej Walczak1, Jan Krekora1, Michał Krejca1, Jarosław Drożdż1
DOI: 10.33963/KP.a2022.0182
·
Pubmed: 35924995
Affiliations
  1. 2nd Department of Cardiology, Medical University of Lodz, Department of Cardiology and Cardiac Surgery of the Hospital of the Clinical and Didactic Centre in Lodz, Łódź, Poland

open access

Online first
Original article
Published online: 2022-08-03

Abstract

Background: Aortic stenosis (AS) is the most common acquired valvular disease. There are two methods of interventional treatment: surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). The choice between SAVR and TAVI depends on the assessment of individual perioperative risk and long-term treatment outcomes. It is essential to identify factors that may influence the outcomes of the treatment in order to minimize their negative effects.

Aims: The aim of the study was to identify the most important risk factor which affects treatment outcomes in patients with AS undergoing SAVR/TAVI.

Methods: This study reviewed retrospectively patients with AS who underwent SAVR and TAVI. The primary outcomes included incidences of major adverse cardiovascular events (MACE) defined as cardiovascular death, stroke and hospitalization due to cardiovascular issues assessed over one-year follow-up period. An occurrence of postprocedural AKI (acute kidney injury) was identified as the independent predictor of MACE.

Results: The study included 78 patients, the same number of subjects in each group (SAVR/TAVI [n = 39]). Twenty-nine patients developed AKI. It was similar in both groups (SAVR [n = 15]; TAVR [n = 14]). In the SAVR group, 13 (33%) of patients developed at least one MACE compared to 5 (13%) of patients in the TAVI group. AKI and the type of procedure (SAVR) were shown to be significantly and independently associated with the development of MACE (P = 0.01 and P = 0.03, respectively) as shown in the Cox multivariable regression model.

Conclusions: Our study revealed that AKI is the strongest predictor of major adverse cardiovascular events after both methods of aortic valve replacement (SAVR/TAVI).

Abstract

Background: Aortic stenosis (AS) is the most common acquired valvular disease. There are two methods of interventional treatment: surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). The choice between SAVR and TAVI depends on the assessment of individual perioperative risk and long-term treatment outcomes. It is essential to identify factors that may influence the outcomes of the treatment in order to minimize their negative effects.

Aims: The aim of the study was to identify the most important risk factor which affects treatment outcomes in patients with AS undergoing SAVR/TAVI.

Methods: This study reviewed retrospectively patients with AS who underwent SAVR and TAVI. The primary outcomes included incidences of major adverse cardiovascular events (MACE) defined as cardiovascular death, stroke and hospitalization due to cardiovascular issues assessed over one-year follow-up period. An occurrence of postprocedural AKI (acute kidney injury) was identified as the independent predictor of MACE.

Results: The study included 78 patients, the same number of subjects in each group (SAVR/TAVI [n = 39]). Twenty-nine patients developed AKI. It was similar in both groups (SAVR [n = 15]; TAVR [n = 14]). In the SAVR group, 13 (33%) of patients developed at least one MACE compared to 5 (13%) of patients in the TAVI group. AKI and the type of procedure (SAVR) were shown to be significantly and independently associated with the development of MACE (P = 0.01 and P = 0.03, respectively) as shown in the Cox multivariable regression model.

Conclusions: Our study revealed that AKI is the strongest predictor of major adverse cardiovascular events after both methods of aortic valve replacement (SAVR/TAVI).

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Keywords

acute kidney injury, major adverse cardiovascular events, severe aortic stenosis, surgical aortic valve replacement, transcatheter aortic valve implantation

About this article
Title

Acute kidney injury as the most important predictor of poor prognosis after interventional treatment for aortic stenosis

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-08-03

Page views

56

Article views/downloads

29

DOI

10.33963/KP.a2022.0182

Pubmed

35924995

Keywords

acute kidney injury
major adverse cardiovascular events
severe aortic stenosis
surgical aortic valve replacement
transcatheter aortic valve implantation

Authors

Anita Korczak
Robert Morawiec
Michał Stegienta
Aleksandra Ryk
Andrzej Walczak
Jan Krekora
Michał Krejca
Jarosław Drożdż

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