Abstract 15440: The Incidence and Outcomes of Acute Kidney Injury After TAVR
Introduction: Acute kidney injury (AKI) is a known complication after cardiovascular procedures and is associated with increased all-cause-mortality.
Hypothesis: We aimed to assess the incidence, predictors, and long-term outcomes of AKI after TAVR.
Methods: We evaluated inoperable patients with severe aortic stenosis who received TAVR in an academic institution from 04/2008 to 06/2015. AKI was defined according to the consensus report of the Valve Academic Research Consortium. Predictors of AKI were evaluated using multivariable logistic regression modeling.
Results: Among 457 patients who underwent TAVR, 78 (17%) developed AKI. There were no differences in age, gender, BMI, hypertension, dyslipidemia, smoking status, or medications use among patients with and without AKI. However, patients with AKI were more likely to have diabetes mellitus (DM), chronic kidney disease (CKD) and prior history of stroke than patients without AKI (Figure). Patients with AKI had also lower baseline hemoglobin (AKI: 11 g/dL vs. No AKI: 12, p=0.004) and higher baseline creatinine (1.45 vs. 1.1, p=<0.001). Procedural characteristics that were associated with AKI included: hypotension, IABP/LV assist device use, bleeding, and vascular complications. Patients with AKI had higher all-cause-mortality (14% vs. 2%, p <0.001), higher median hospital length of stay (12 vs. 7 days, p <0.001) and a higher incidence of new dialysis requirement (12% vs. 1%, p <0.001), and dialysis at one month (8% vs. 1%, p =0.001). Multivariate logistsic regression analysis identified DM, CKD, and IABP or LV assist device use as independent predictors of AKI.
Conclusion: Our results suggest that AKI is relatively common post TAVR and it is associated with increased mortality, length of stay, and dialysis requirement. Patients with underlying CKD and DM who require IABP or LV assist devices for hemodynamic support are at the highest risk of AKI.
Author Disclosures: A. Damluji: None. M. Murman: None. D. Painter: None. Y.E. Alansari: None. M. Kabach: None. I. Novoa: None. R.G. Carrillo: None. D.B. Williams: Research Grant; Modest; Edwards Lifesciences. E.J. de Marchena: None. C.A. Martinez: None. C. Alfonso: None. M. Moscucci: None. A.W. Heldman: Research Grant; Modest; Edwards Lifesciences. L. Leroux: None. M.G. Cohen: Research Grant; Modest; Edwards Lifesciences.
- © 2015 by American Heart Association, Inc.