Antonio C B Nunes Filho1, Marcelo Katz2, Carlos M Campos3, Luiz A Carvalho4, Dimytri A Siqueira5, Rogério T Tumelero6, Antenor L F Portella7, Vinícius Esteves8, Marco A Perin9, Rogério Sarmento-Leite10, Pedro A Lemos Neto3, Flavio Tarasoutchi3, Hiram G Bezerra11, Fábio S de Brito9. 1. Department of Cardiology, Hospital Israelita Albert Einstein, São Paulo, Brazil. Electronic address: antonio.filho@einstein.br. 2. Department of Cardiology, Hospital Israelita Albert Einstein, São Paulo, Brazil. 3. Department of Interventional Cardiology, Hospital Israelita Albert Einstein, São Paulo, Brazil; Department of Interventional Cardiology, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. 4. Department of Interventional Cardiology, Hospital Pró-Cardíaco, Rio de Janeiro, Brazil. 5. Department of Interventional Cardiology, Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil. 6. Department of Interventional Cardiology, Hospital São Vicente de Paulo, Passo Fundo, Brazil. 7. Department of Interventional Cardiology, Hospital São Marcos, Teresina, Brazil. 8. Department of Interventional Cardiology, Rede D'OR São Luiz, São Paulo, Brazil. 9. Department of Interventional Cardiology, Hospital Israelita Albert Einstein, São Paulo, Brazil. 10. Department of Interventional Cardiology, Instituto de Cardiologia, Porto Alegre, Brazil. 11. Cardiac Catheterization Laboratory, UH Cleveland Medical Center, Cleveland, United States.
Abstract
INTRODUCTION AND OBJECTIVES: Acute kidney injury (AKI) is frequently observed after transcatheter aortic valve implantation (TAVI) and is associated with higher mortality. However, the impact of AKI on long-term outcomes remains controversial. Therefore, we sought to evaluate the impact of AKI on short- and long-term outcomes following TAVI using the Valve Academic Research Consortium 2 criteria. METHODS: Consecutive patients (n = 794) with severe aortic stenosis who underwent TAVI were included in a multicenter Brazilian registry. Logistic regression analysis was used to identify predictors of AKI. Four-year outcomes were determined as Kaplan-Meier survival curves, and an adjusted landmark analysis was used to test the impact of AKI on mortality among survivors at 12 months. RESULTS: The incidence of AKI after TAVI was 18%. Independent predictors of AKI were age, diabetes mellitus, major or life-threatening bleeding and valve malpositioning. Acute kidney injury was independently associated with higher risk of all-cause death (adjusted HR, 2.8; 95%CI, 2.0-3.9; P < .001) and cardiovascular mortality (adjusted HR, 2.9; 95%CI, 1.9-4.4; P < .001) over the entire follow-up period. However, when considering only survivors at 12 months, there was no difference in both clinical endpoints (adjusted HR, 1.2; 95%CI, 0.5-2.4; P = .71, and HR, 0.7; 95%CI, 0.2-2.1; P = .57, respectively). CONCLUSIONS: Acute kidney injury is a frequent complication after TAVI. Older age, diabetes, major or life-threatening bleeding, and valve malpositioning were independent predictors of AKI. Acute kidney injury is associated with worse short- and long-term outcomes. However, the major impact of AKI on mortality is limited to the first year after TAVI.
INTRODUCTION AND OBJECTIVES:Acute kidney injury (AKI) is frequently observed after transcatheter aortic valve implantation (TAVI) and is associated with higher mortality. However, the impact of AKI on long-term outcomes remains controversial. Therefore, we sought to evaluate the impact of AKI on short- and long-term outcomes following TAVI using the Valve Academic Research Consortium 2 criteria. METHODS: Consecutive patients (n = 794) with severe aortic stenosis who underwent TAVI were included in a multicenter Brazilian registry. Logistic regression analysis was used to identify predictors of AKI. Four-year outcomes were determined as Kaplan-Meier survival curves, and an adjusted landmark analysis was used to test the impact of AKI on mortality among survivors at 12 months. RESULTS: The incidence of AKI after TAVI was 18%. Independent predictors of AKI were age, diabetes mellitus, major or life-threatening bleeding and valve malpositioning. Acute kidney injury was independently associated with higher risk of all-cause death (adjusted HR, 2.8; 95%CI, 2.0-3.9; P < .001) and cardiovascular mortality (adjusted HR, 2.9; 95%CI, 1.9-4.4; P < .001) over the entire follow-up period. However, when considering only survivors at 12 months, there was no difference in both clinical endpoints (adjusted HR, 1.2; 95%CI, 0.5-2.4; P = .71, and HR, 0.7; 95%CI, 0.2-2.1; P = .57, respectively). CONCLUSIONS:Acute kidney injury is a frequent complication after TAVI. Older age, diabetes, major or life-threatening bleeding, and valve malpositioning were independent predictors of AKI. Acute kidney injury is associated with worse short- and long-term outcomes. However, the major impact of AKI on mortality is limited to the first year after TAVI.
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Deborah Carvalho Malta; Andreia Biolo; Bruno Ramos Nascimento; Maria de Fatima Marinho de Souza; Andrea Rocha De Lorenzo; Antonio Aurélio de Paiva Fagundes Júnior; Beatriz D Schaan; Fábio Morato de Castilho; Fernando Henpin Yue Cesena; Gabriel Porto Soares; Gesner Francisco Xavier Junior; Jose Augusto Soares Barreto Filho; Luiz Guilherme Passaglia; Marcelo Martins Pinto Filho; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Paolo Blanco Villela; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Pablo Perel; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2022-01 Impact factor: 2.000
Authors: Michel V Lemes da Silva; Antonio C B Nunes Filho; Vitor E E Rosa; Adriano Caixeta; Pedro A Lemos Neto; Henrique B Ribeiro; Breno O Almeida; José Mariani; Carlos M Campos; Alexandre A C Abizaid; José A Mangione; Roney O Sampaio; Paulo Caramori; Rogério Sarmento-Leite; Flávio Tarasoutchi; Marcelo Franken; Fábio S de Brito Journal: PLoS One Date: 2021-05-13 Impact factor: 3.240
Authors: Gláucia Maria Moraes de Oliveira; Luisa Campos Caldeira Brant; Carisi Anne Polanczyk; Andreia Biolo; Bruno Ramos Nascimento; Deborah Carvalho Malta; Maria de Fatima Marinho de Souza; Gabriel Porto Soares; Gesner Francisco Xavier Junior; M Julia Machline-Carrion; Marcio Sommer Bittencourt; Octavio M Pontes Neto; Odilson Marcos Silvestre; Renato Azeredo Teixeira; Roney Orismar Sampaio; Thomaz A Gaziano; Gregory A Roth; Antonio Luiz Pinho Ribeiro Journal: Arq Bras Cardiol Date: 2020-09 Impact factor: 2.667
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