Ilker Gul1, Mustafa Zungur1, Ahmet Tastan1, Faik Fevzi Okur2, Ertan Damar3, Samet Uyar1, Veysel Sahin2, Talat Tavli1. 1. Department of Cardiology, Faculty of Medicine, Sifa University, Izmir, Turkey. 2. Department of Cardiovascular Surgery, Faculty of Medicine, Sifa University, Izmir, Turkey. 3. Department of Anesthesiology and Reanimation, Faculty of Medicine, Sifa University, Izmir, Turkey.
Abstract
BACKGROUND/AIM: Transcatheter aortic valve implantation (TAVI) is a method which is increasingly applied in severe aortic stenosis treatment. The development of contrast-induced nephropathy (CIN) after TAVI increases morbidity and mortality rates. Within the scope of this study, the importance of the contrast medium volume to glomerular filtration rate (CV/GFR) ratio in determining the development of CIN and the amount of CV that could be applied was evaluated. METHODS: Seventy-two patients (aged 78.6 ± 11.6 years; 38 females) who underwent aortic valve replacement with the TAVI method between June 2013 and August 2014 were included in the study. CIN was defined as an absolute increase in serum creatinine of >0.5 mg/dl or a relative increase of >25% within 48-72 h after TAVI. CIN+ and CIN-patients were classified into two groups. The χ(2) test, t test, Mann-Whitney U test, ROC analysis, and univariate and multivariate regression analyses were applied for statistical analyses. RESULTS: CIN was detected in 16 patients (22%) in our study. Baseline creatinine, baseline GFR, the Mehran risk score, CV, and the CV/GFR ratio were determined as the predictive factors of CIN development. A CV/GFR ratio of 3.9 was specified to predict CIN development with 71% sensitivity and 80% specificity. CONCLUSION: After TAVI, CIN may develop due to various reasons. In patients to whom TAVI was applied, the CV/GFR ratio may be a guideline helping to prevent the development of renal pathologies. The amount of contrast medium that can be given to a patient can be calculated in terms of baseline GFR.
BACKGROUND/AIM: Transcatheter aortic valve implantation (TAVI) is a method which is increasingly applied in severe aortic stenosis treatment. The development of contrast-induced nephropathy (CIN) after TAVI increases morbidity and mortality rates. Within the scope of this study, the importance of the contrast medium volume to glomerular filtration rate (CV/GFR) ratio in determining the development of CIN and the amount of CV that could be applied was evaluated. METHODS: Seventy-two patients (aged 78.6 ± 11.6 years; 38 females) who underwent aortic valve replacement with the TAVI method between June 2013 and August 2014 were included in the study. CIN was defined as an absolute increase in serum creatinine of >0.5 mg/dl or a relative increase of >25% within 48-72 h after TAVI. CIN+ and CIN-patients were classified into two groups. The χ(2) test, t test, Mann-Whitney U test, ROC analysis, and univariate and multivariate regression analyses were applied for statistical analyses. RESULTS:CIN was detected in 16 patients (22%) in our study. Baseline creatinine, baseline GFR, the Mehran risk score, CV, and the CV/GFR ratio were determined as the predictive factors of CIN development. A CV/GFR ratio of 3.9 was specified to predict CIN development with 71% sensitivity and 80% specificity. CONCLUSION: After TAVI, CIN may develop due to various reasons. In patients to whom TAVI was applied, the CV/GFR ratio may be a guideline helping to prevent the development of renal pathologies. The amount of contrast medium that can be given to a patient can be calculated in terms of baseline GFR.
Authors: Martin B Leon; Craig R Smith; Michael Mack; D Craig Miller; Jeffrey W Moses; Lars G Svensson; E Murat Tuzcu; John G Webb; Gregory P Fontana; Raj R Makkar; David L Brown; Peter C Block; Robert A Guyton; Augusto D Pichard; Joseph E Bavaria; Howard C Herrmann; Pamela S Douglas; John L Petersen; Jodi J Akin; William N Anderson; Duolao Wang; Stuart Pocock Journal: N Engl J Med Date: 2010-09-22 Impact factor: 91.245
Authors: George Dangas; Ioannis Iakovou; Eugenia Nikolsky; Eve D Aymong; Gary S Mintz; Nicholas N Kipshidze; Alexandra J Lansky; Issam Moussa; Gregg W Stone; Jeffrey W Moses; Martin B Leon; Roxana Mehran Journal: Am J Cardiol Date: 2005-01-01 Impact factor: 2.778
Authors: David H Adams; Jeffrey J Popma; Michael J Reardon; Steven J Yakubov; Joseph S Coselli; G Michael Deeb; Thomas G Gleason; Maurice Buchbinder; James Hermiller; Neal S Kleiman; Stan Chetcuti; John Heiser; William Merhi; George Zorn; Peter Tadros; Newell Robinson; George Petrossian; G Chad Hughes; J Kevin Harrison; John Conte; Brijeshwar Maini; Mubashir Mumtaz; Sharla Chenoweth; Jae K Oh Journal: N Engl J Med Date: 2014-03-29 Impact factor: 91.245
Authors: Alec Vahanian; Ottavio Alfieri; Felicita Andreotti; Manuel J Antunes; Gonzalo Barón-Esquivias; Helmut Baumgartner; Michael Andrew Borger; Thierry P Carrel; Michele De Bonis; Arturo Evangelista; Volkmar Falk; Bernard Lung; Patrizio Lancellotti; Luc Pierard; Susanna Price; Hans-Joachim Schäfers; Gerhard Schuler; Janina Stepinska; Karl Swedberg; Johanna Takkenberg; Ulrich Otto Von Oppell; Stephan Windecker; Jose Luis Zamorano; Marian Zembala Journal: Eur J Cardiothorac Surg Date: 2012-08-25 Impact factor: 4.191
Authors: Martin B Leon; Nicolo Piazza; Eugenia Nikolsky; Eugene H Blackstone; Donald E Cutlip; Arie Pieter Kappetein; Mitchell W Krucoff; Michael Mack; Roxana Mehran; Craig Miller; Marie-Angèle Morel; John Petersen; Jeffrey J Popma; Johanna J M Takkenberg; Alec Vahanian; Gerrit-Anne van Es; Pascal Vranckx; John G Webb; Stephan Windecker; Patrick W Serruys Journal: Eur Heart J Date: 2011-01-06 Impact factor: 29.983
Authors: Gabriele Venturi; Roberto Scarsini; Michele Pighi; Rafail A Kotronias; Anna Piccoli; Mattia Lunardi; Paolo Del Sole; Andrea Mainardi; Alessia Gambaro; Domenico Tavella; Giovanni L De Maria; Rajesh Kharbanda; Gabriele Pesarini; Adrian Banning; Flavio Ribichini Journal: Catheter Cardiovasc Interv Date: 2022-03-21 Impact factor: 2.585