Abstract:
AIMS:Very few data exist on the occurrence of acute kidney injury (AKI) associated with transcatheter aortic valve implantation (TAVI). The objectives of the present study were (i) to determine the incidence, predictive factors, and prognostic value of AKI following TAVI, and (ii) to compare the occurrence of AKI in TAVI vs. surgical aortic valve replacement (SAVR) in patients with pre-procedural chronic kidney disease (CKD). METHODS AND RESULTS:A total of 213 patients (mean age 82 +/- 8 years) undergoing TAVI for the treatment of severe aortic stenosis were included in the study. Acute kidney injury was defined as a reduction of >25% in estimated glomerular filtration rate (eGFR) within 48 h following the procedure or the need for haemodialysis during index hospitalization. Those patients with pre-procedural CKD (eGFR <60 mL/min/1.73 m(2), n = 119) were compared with 104 contemporary patients with CKD who underwent isolated SAVR. The incidence of AKI following TAVI was 11.7%, with 1.4% of the patients requiring haemodialysis. Predictive factors of AKI were hypertension (OR: 4.66; 95% CI: 1.04-20.87), chronic obstructive pulmonary disease (OR: 2.64, 95% CI: 1.10-6.36), and peri-operative blood transfusion (OR: 3.47, 95% CI: 1.30-9.29). Twenty-one patients (9.8%) died during index hospitalization, and the logistic EuroSCORE (OR: 1.03 for each increase of 1%; 95% CI: 1.01-1.06) and occurrence of AKI (OR: 4.14, 95% CI: 1.42-12.13) were identified as independent predictors of postoperative mortality. Patients with CKD who underwent TAVI were older, had a higher logistic EuroSCORE and lower pre-procedural eGFR values compared with those who underwent SAVR (P < 0.0001 for all). The incidence of AKI was lower (P = 0.001; P = 0.014 after propensity score adjustment) in CKD patients who underwent TAVI (9.2%, need for haemodialysis: 2.5%) compared with those who underwent SAVR (25.9%, need for haemodialysis: 8.7%). CONCLUSION:Acute kidney injury occurred in 11.7% of the patients following TAVI and was associated with a greater than four-fold increase in the risk of postoperative mortality. Hypertension, chronic obstructive pulmonary disease, and blood transfusion were predictive factors of AKI. In those patients with pre-procedural CKD, TAVI was associated with a significant reduction of AKI compared with SAVR.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Bagur R,Webb JG,Nietlispach F,Dumont E,De Larochellière R,Doyle D,Masson JB,Gutiérrez MJ,Clavel MA,Bertrand OF,Pibarot P,Rodés-Cabau Jdoi
10.1093/eurheartj/ehp552subject
Has Abstractpub_date
2010-04-01 00:00:00pages
865-74issue
7eissn
0195-668Xissn
1522-9645pii
ehp552journal_volume
31pub_type
杂志文章,多中心研究abstract::The natriuretic peptides are important tools to establish diagnosis and prognosis in heart failure (HF). With application of therapies for HF, changes in both B-type natriuretic peptide (BNP) and its amino terminal cleavage fragment (NT-proBNP) parallel the benefits of the HF therapy applied. This dynamic nature of BN...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/eht463
更新日期:2014-01-01 00:00:00
abstract:AIM:Decreasing cholesterol levels in Western populations is the main reason for decreasing mortality due to coronary heart disease. Our aim was to analyze trends in cholesterol levels in the population during a period of 20 years in relation to previous cardiovascular disease (CVD), other cardiovascular risk factors, a...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehw052
更新日期:2016-07-01 00:00:00
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journal_title:European heart journal
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doi:10.1053/euhj.1997.0803
更新日期:1998-04-01 00:00:00
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更新日期:2000-07-01 00:00:00
abstract::A series of 42 patients with chest pain but normal coronary angiograms and normal haemodynamics at rest were prospectively classified as typical angina (group 1, N = 9) or atypical angina (group 2, N = 16) or non-anginal chest pain (group 3, N = 17). All patients underwent radionuclide ventriculography and measurement...
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abstract:AIMS:To investigate personality traits and sympatho-vagal modulation of heart rate variability (HRV) during acute myocardial infarction (AMI), assessing their relationships and their long-term prognostic value. METHODS AND RESULTS:Psychological traits and 24 h HRV were prospectively investigated in 246 patients at dis...
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更新日期:2005-08-01 00:00:00
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更新日期:2017-04-07 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2005-08-01 00:00:00
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更新日期:2014-09-07 00:00:00
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更新日期:1988-05-01 00:00:00
abstract:AIMS:Experimental and clinical studies indicate that tea exerts protection against cardiovascular diseases. However, a question of much debate is whether addition of milk modifies the biological activities of tea. We studied the vascular effects of tea, with or without milk, in humans and elucidated the impact of indiv...
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更新日期:2011-03-01 00:00:00
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更新日期:1984-09-01 00:00:00
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更新日期:2017-03-01 00:00:00
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更新日期:1990-08-01 00:00:00
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pub_type: 杂志文章,多中心研究
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2007-05-01 00:00:00
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更新日期:1993-12-01 00:00:00
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pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2011-10-01 00:00:00
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更新日期:2020-03-07 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1995-11-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a062501
更新日期:1988-03-01 00:00:00