title: Clinical impact of acute kidney injury on short- and long-term outcomes after transcatheter aortic valve implantation with the CoreValve prosthesis.
abstract: BACKGROUND
  Acute kidney injury (AKI) after cardiac surgery is associated with increased mortality, but few data exist on the occurrence and clinical impact of AKI associated with transcatheter aortic valve implantation (TAVI). The objective of this study was to determine the incidence and prognosis of AKI after percutaneous implantation of the CoreValve(®) (Medtronic, Minneapolis, MN, USA) prosthesis.
  
  
  METHODS
  A total of 357 patients with severe aortic stenosis and 9 patients with pure native aortic regurgitation were treated with the CoreValve prosthesis. AKI was defined according to Valve Academic Research Consortium criteria as the absolute increase in serum creatinine ≥0.3mg/dl at 72h post percutaneous procedure.
  
  
  RESULTS
  AKI was identified in 58 patients (15.8%), none of whom required renal replacement therapy. In patients with AKI, the mortality at 30 days was 13.5% compared with 1.6% of patients without AKI, [odds ratio (OR)=12.2 (95% CI 3.53-41.9); p<0.001] and total mortality after a mean of 26.2±17 months was 29.3% vs. 14.9% [OR=2.36 (95% CI 1.23-4.51), p=0.008]. In the multivariate analysis, AKI was an independent predictor of cumulative total mortality [hazard ratio=2.151, (95% CI from 1.169 to 3.957), p=0.014].
  
  
  CONCLUSIONS
  The deterioration of renal function in patients undergoing TAVI with the CoreValve prosthesis is a serious and frequent complication. The occurrence of AKI was associated with increased early mortality and was also a predictor of worse outcomes in follow-up.
authors.affiliation: Department of Cardiology, Instituto de Biomedicina de Málaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Málaga, University of Málaga, Spain. Electronic address: ajmunozgarcia@secardiologia.es.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Muñoz-García
authors.affiliation: Department of Cardiology, Instituto de Biomedicina de Málaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Málaga, University of Málaga, Spain.
authors.forename: Erika
authors.initials: E
authors.lastname: Muñoz-García
authors.affiliation: Department of Cardiology, Instituto de Biomedicina de Málaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Málaga, University of Málaga, Spain.
authors.forename: Manuel F
authors.initials: MF
authors.lastname: Jiménez-Navarro
authors.affiliation: Department of Cardiology, Instituto de Biomedicina de Málaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Málaga, University of Málaga, Spain.
authors.forename: Antonio J
authors.initials: AJ
authors.lastname: Domínguez-Franco
authors.affiliation: Department of Cardiology, Instituto de Biomedicina de Málaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Málaga, University of Málaga, Spain.
authors.forename: Juan H
authors.initials: JH
authors.lastname: Alonso-Briales
authors.affiliation: Department of Cardiology, Instituto de Biomedicina de Málaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Málaga, University of Málaga, Spain.
authors.forename: José M
authors.initials: JM
authors.lastname: Hernández-García
authors.affiliation: Department of Cardiology, Instituto de Biomedicina de Málaga (IBIMA), Virgen de la Victoria Clinical University Hospital, Málaga, University of Málaga, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Teresa-Galván
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D000368:Aged; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D016017:Odds Ratio; D011379:Prognosis; D013030:Spain / Q000453:epidemiology; D016019:Survival Analysis; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: Acute kidney injury; Aortic stenosis; Prognosis; Transcatheter aortic valve implantation