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Predictors of Acute Kidney Injury after Transcatheter Aortic Valve Replacement
Session:
SESSÃO DE POSTERS 24 - COMPLICAÇÕES NA INTERVENÇÃO VALVULAR AÓRTICA PERCUTÂNEA
Speaker:
Miguel Caramelo Abrantes de Figueiredo
Congress:
CPC 2025
Topic:
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme:
15. Valvular Heart Disease
Subtheme:
15.4 Valvular Heart Disease – Treatment
Session Type:
Cartazes
FP Number:
---
Authors:
Miguel Abrantes De Figueiredo; Inês Rodrigues; Bárbara Teixeira; André Grazina; Francisco Albuquerque; Ricardo Carvalheiro; Tiago Mendonça; Rúben Ramos; António Fiarresga; Rui Cruz Ferreira; Duarte Cacela
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Background:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> Transcatheter Aortic Valve Replacement (TAVR) is an increasingly more frequent treatment for severe aortic valve stenosis, particularly in high surgical risk patients. Acute Kidney Injury (AKI) is a common complication associated with TAVR.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Aim:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> This study aims to identify clinical, analytical and procedure-related risk factors associated with AKI after TAVR.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Methods:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> This was a retrospective study of all patients undergoing TAVR since January 2012 to November 2023 in one high-volume tertiary care center in Portugal. AKI was identified and categorized according to the Valve Academy Research Consortium (VARC)-2 criteria. Independent-samples t-test and chi-square were used to identify statistical significance between potential risk factors and AKI. Independent risk factors for AKI following TAVR were derived using binary logistic regression.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Results:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> AKI was present in 18.2% of patients after TAVR. Of the several variables analyzed, age, history of chronic kidney disease (CKD), hypertension, diabetes, vascular access complications, clinically significant hemorrhage and fall in hemoglobin were statistically significantly (p-value < 0.05) associated with AKI following TAVR. Binary logistic regression showed that history of CKD (OR: 2.909; 95% CI: 1.998 - 4.235; p < 0.001) and fall in hemoglobin (OR: 1.540; 95% CI: 1.352 - 1.754; p < 0.001) were very strong independent risk factors for AKI after TAVR. Additionally, the association between contrast volume and AKI was not statistically significant (p-value = 0.064).</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Conclusion:</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"> AKI is a frequent complication after TAVR, with an incidence of 18.2% in this patient cohort. History of CKD and a decrease in hemoglobin are very strong independent predictors of AKI in patients undergoing TAVR.</span></span></span></span></p>
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