Author + information
- Stephan Haussig,
- Felix Woitek,
- Norman Mangner,
- Sergey Leontyev,
- David Holzhey,
- Friedrich Mohr,
- Gerhard Schuler and
- Axel Linke
Background: Occurrence of acute kidney injury after transcatheter aortic valve replacement (TAVR) increases morbidity and mortality. Higher B-type natriuretic peptide (BNP) levels are known to be associated with acute kidney injury (AKI) in patients after acute myocardial infarction. Aim of this study was to evaluate the impact of higher BNP levels at baseline on the occurrence of AKI after TAVR in a prospective single center registry.
Methods: Patients with severe aortic stenosis in which TAVR was performed between 2006 and 2014 were included into the analysis. BNP was measured at baseline. Occurrence of AKI was assessed according to VARC definitions. 30-day, 1-year and 2-year mortality was calculated.
Results: Between January 2006 and September 2014 a total of 1822 consecutive patients (Age 80.3±5.9 years, Logistic EuroScore 19.3±13.2%, STS PROM 8.3±6.0%) with severe aortic stenosis were treated with TAVR at our institution. Baseline BNP values were available for 1401 patients. Overall mortality was 6.9% at 30 days, 20.5% at 1 year, and 24,7% at 2 years. AKI occurred in 302 patients after TAVR. Patients with AKI showed significantly higher mortality rates compared to patients without AKI at 30 days (24,7% vs. 3.3%, p<0.001), at one year (47.8% vs. 14.9%, p<0.001), and at two years (50.8% vs. 19.4%, p<0.001). Patients with AKI had significantly higher median baseline BNP levels compared to patients without AKI [2748 (IQR 1374;6435) vs. 1750 (IQR 770;4511), p<0.001). There was no significant difference in EF between patients with or without AKI (54.8±14.1% vs. 54.6±14.5%, p=0.87).
Conclusions: Patients with AKI after TAVR had significantly higher BNP values at baseline. High BNP values may be due to diastolic dysfunction and possibly indicate elevation of central venous pressure and passive renal congestion. Further studies are necessary to confirm the best cutoff value for predicting AKI.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: TAVR 2
Abstract Category: 17. Interventional Cardiology: Aortic Valve Disease
Presentation Number: 1195-186
- 2017 American College of Cardiology Foundation