title: Safety of same-day coronary angiography in patients undergoing elective aortic valve replacement.
abstract: BACKGROUND
  Coronary artery imaging is required for most adult patients undergoing aortic valve replacement (AVR).
  
  
  METHODS
  Between January 1, 2000, and December 31, 2007, 1413 patients underwent elective AVR at Mayo Clinic. Two propensity-matched groups at low risk for acute kidney injury were created: 321 patients with coronary angiography on the same day as AVR (same day) and 321 patients with coronary angiography more than 1 day before AVR (non-same day). We defined acute postoperative kidney injury with Acute Kidney Injury Network criteria (≥0.3 mg/dL or a 50% increase in serum creatinine from baseline).
  
  
  RESULTS
  The same-day vs non-same-day groups were comparable in age (mean [SD] years: 70.6 [11.0] vs 70.8 [11.5]), sex (111 women [34.6%] vs 114 women [35.5%]), preoperative serum creatinine (1.14 [0.22] vs 1.15 [0.23] mg/dL), and ejection fraction (0.62 [0.12] vs 0.61 [0.12]). Coronary artery revascularization was performed in 118 patients (36.8%) in the same-day group and in 123 (38.3%) in the non-same-day group (p=0.68). Maximum (30-day) postoperative serum creatinine levels were not significantly different between the same-day and non-same day groups (1.30 [0.43] mg/dL vs 1.29 [0.42] mg/dL; p=0.87). Perioperative (30-day) acute kidney injury occurred in 75 patients (23.4%) in the same-day group and in 71 (22.3%) in the non-same-day group (p=0.99). Perioperative (30-day) death occurred in 5 patients (1.6%) in the same-day group and in 7 (2.2%) in the non-same-day group (p=0.56). Other nonfatal complications rates were comparable between groups.
  
  
  CONCLUSIONS
  In properly selected patients, coronary angiography can be performed the same day as elective AVR with no increase in perioperative morbidity or death.
authors.affiliation: Division of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA. greason.kevin@mayo.edu
authors.forename: Kevin L
authors.initials: KL
authors.lastname: Greason
authors.forename: Lars
authors.initials: L
authors.lastname: Englberger
authors.forename: Rakesh M
authors.initials: RM
authors.lastname: Suri
authors.forename: Soon J
authors.initials: SJ
authors.lastname: Park
authors.forename: Charanjit S
authors.initials: CS
authors.lastname: Rihal
authors.forename: Sorin V
authors.initials: SV
authors.lastname: Pislaru
authors.forename: Hartzell V
authors.initials: HV
authors.lastname: Schaff
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology*; D000368:Aged; D001021:Aortic Valve / Q000601:surgery*; D017023:Coronary Angiography / Q000009:adverse effects*; D003404:Creatinine / Q000097:blood; D017558:Elective Surgical Procedures; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D003404:Creatinine