Yuya Adachi1, Masanori Yamamoto2, Tetsuro Shimura1, Ryo Yamaguchi1, Ai Kagase3, Takahiro Tokuda3, Satoshi Tsujimoto3, Yutaka Koyama3, Toshiaki Otsuka4, Fumiaki Yashima5, Norio Tada6, Toru Naganuma7, Motoharu Araki8, Futoshi Yamanaka9, Shinichi Shirai10, Kazuki Mizutani11, Minoru Tabata12, Hiroshi Ueno13, Kensuke Takagi14, Yusuke Watanabe15, Kentaro Hayashida16. 1. Department of Cardiology, Toyohashi Heart Center, Aichi, Japan. 2. Department of Cardiology, Toyohashi Heart Center, Aichi, Japan; Department of Cardiology, Nagoya Heart Center, Aichi, Japan. Electronic address: masa-nori@nms.ca.jp. 3. Department of Cardiology, Nagoya Heart Center, Aichi, Japan. 4. Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan; Center for Clinical Research, Nippon Medical School Hospital, Tokyo, Japan. 5. Department of Cardiology, Saiseikai Utsunomiya Hospital, Tochigi, Japan; Department of Cardiology, Keio University School of Medicine, Tokyo, Japan. 6. Department of Cardiology, Sendai Kosei Hospital, Miyagi, Japan. 7. Department of Cardiology, New Tokyo Hospital, Chiba, Japan. 8. Department of Cardiology, Saiseikai Yokohama City Eastern Hospital, Kanagawa, Japan. 9. Department of Cardiology, Shonan Kamakura General Hospital, Kanagawa, Japan. 10. Department of Cardiology, Kokura Memorial Hospital, Fukuoka, Japan. 11. Department of Cardiology, Osaka City General Hospital, Osaka, Japan. 12. Department of Cardiovascular Surgery, Tokyo Bay Urayasu-Ichikawa Medical Center, Chiba, Japan. 13. Department of Cardiology, Toyama University Hospital, Toyama, Japan. 14. Department of Cardiology, Ogaki Municipal Hospital, Gifu, Japan. 15. Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan. 16. Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
Abstract
BACKGROUND: Information on early to late-phase kidney damage in patients who underwent transcatheter aortic valve replacement (TAVR) is scarce. We aimed to identify the predictive factors for late kidney injury (LKI) at 1-year and patient prognosis beyond 1-year after TAVR. METHODS: We retrospectively reviewed 1,705 patients' data from the Japanese TAVR multicenter registry. Acute kidney injury (AKI) and LKI, defined as an increase of at least 0.3 mg/dL in creatinine level, a relative 50% decrease in kidney function from baseline to 48 hours and 1-year, were evaluated. The patients were categorized into the 4 groups as AKI-/LKI- (n = 1.362), AKI+/LKI- (n = 95), AKI-/LKI+ (n = 199), and AKI+/LKI+ (n = 46). RESULTS: The cumulative 3-year mortality rates were significantly increased across the four groups (12.5%, 15.8%, 24.6%, 25.8%, P < .001). Multivariate analysis revealed that chronic kidney disease, coronary artery disease, periprocedural AKI, and heart failure-related re-admission within 1-year were significantly associated with LKI. The Cox regression analysis revealed that AKI-/LKI+ and AKI+/LKI+ were independent predictors of increased late mortality beyond 1-year after TAVR (P = .001 and P = .01). CONCLUSIONS: LKI was influenced by adverse cardio-renal events and was associated with increased risks of late mortality beyond 1-year after TAVR.
BACKGROUND: Information on early to late-phase kidney damage in patients who underwent transcatheter aortic valve replacement (TAVR) is scarce. We aimed to identify the predictive factors for late kidney injury (LKI) at 1-year and patient prognosis beyond 1-year after TAVR. METHODS: We retrospectively reviewed 1,705 patients' data from the Japanese TAVR multicenter registry. Acute kidney injury (AKI) and LKI, defined as an increase of at least 0.3 mg/dL in creatinine level, a relative 50% decrease in kidney function from baseline to 48 hours and 1-year, were evaluated. The patients were categorized into the 4 groups as AKI-/LKI- (n = 1.362), AKI+/LKI- (n = 95), AKI-/LKI+ (n = 199), and AKI+/LKI+ (n = 46). RESULTS: The cumulative 3-year mortality rates were significantly increased across the four groups (12.5%, 15.8%, 24.6%, 25.8%, P < .001). Multivariate analysis revealed that chronic kidney disease, coronary artery disease, periprocedural AKI, and heart failure-related re-admission within 1-year were significantly associated with LKI. The Cox regression analysis revealed that AKI-/LKI+ and AKI+/LKI+ were independent predictors of increased late mortality beyond 1-year after TAVR (P = .001 and P = .01). CONCLUSIONS: LKI was influenced by adverse cardio-renal events and was associated with increased risks of late mortality beyond 1-year after TAVR.