title: Impact of pre- and post-procedural anemia on the incidence of acute kidney injury and 1-year mortality in patients undergoing transcatheter aortic valve implantation (from the French Aortic National CoreValve and Edwards 2 [FRANCE 2] Registry).
abstract: OBJECTIVE
  The relationship between anemia, renal insufficiency, and the outcomes of TAVI patients has not been thoroughly studied. We aimed to evaluate the influence of pre- and post-procedural anemia on the incidence of renal insufficiency, especially AKI, and on the outcomes of TAVI.
  
  
  METHODS
  Data from the French national TAVI registry were collected in 3,472 patients who underwent TAVI between January 2010 and December 2012. Of these 2,137 were in the no/mild anemia group, 748 were in the moderate anemia group, and 587 were in the severe anemia group before TAVI. Furthermore, we divided the 3,472 patients into three groups according to post-procedural anemia, measured as post-procedural hemoglobin (Hb) drop: <2 g/dl (n=1,633, group 1), 2 to <4 g/dl (n=1,458, group 2), and >4 g/dl (n = 381, group 3). Procedure and outcome variables were compared.
  
  
  RESULTS
  Increased severity of anemia before TAVI was associated with significantly different rates of 1-year mortality (15%, 19%, and 24%, P<0.01), with similar differences in the incidence of AKI (5%, 8%, and 10%, P<0.01). Increased severity of Hb drop was associated with significantly different rates of 1-year mortality (16%, 18%, and 23%, P<0.01), and with similar differences in the incidence of AKI (6%, 7%, and 10%, P=0.04). Both pre- and post-procedural anemia were predictors of the incidence of AKI (OR 1.82, P<0.01; OR 1.82, P<0.01, respectively) and 1-year mortality (HR 1.44, P<0.01; HR 1.50, P<0.01, respectively).
  
  
  CONCLUSIONS
  Both pre- and post-procedural anemia were significantly associated AKI and 1-year mortality.
authors: Department of Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Takahide
authors: T
authors: Arai
authors: Department of Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Marie-Claude
authors: MC
authors: Morice
authors: Department of Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Stephen A
authors: SA
authors: O'Connor
authors: Department of Cardiology, Centre Hospitalier Universitaire Henri Mondor, Creteil, France.|Department of Cardiology, Toyohashi Heart Center, Aichi, Japan.
authors: Masanori
authors: M
authors: Yamamoto
authors: Department of Cardiology, CHU Rouen, Rouen, France.
authors: Hélène
authors: H
authors: Eltchaninoff
authors: Department of Cardiovascular Surgery, CHU Rennes, Rennes, France.
authors: Alain
authors: A
authors: Leguerrier
authors: Department of Cardiovascular Surgery, CHU Pitie-Salpétrière, Paris, France.
authors: Pascal
authors: P
authors: Leprince
authors: Department of Cardiology, CHU Dupuytren, Limoges, France.
authors: Marc
authors: M
authors: Laskar
authors: Department of Cardiology, CHU Bichat, Paris, France.
authors: Bernard
authors: B
authors: Iung
authors: Department of Cardiology, Clinique Pasteur, Toulose, France.
authors: Jean
authors: J
authors: Fajadet
authors: Department of Cardiovascular Surgery, CHU Lille, Lille, France.
authors: Alain
authors: A
authors: Prat
authors: Department of Cardiology, University Lyon 1, Lyon, France.
authors: Michel
authors: M
authors: Lièvre
authors: Department of Cardiovascular Surgery, Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Patrick
authors: P
authors: Donzeau-Gouge
authors: Department of Cardiology, Centre Hospitalier Universitaire Henri Mondor, Creteil, France.
authors: Karine
authors: K
authors: Chevreul
authors: Department of Cardiology, Centre Hospitalier Universitaire Henri Mondor, Creteil, France.
authors: Emmanuel
authors: E
authors: Teiger
authors: Department of Cardiology, Institut Cardiovasculaire Paris Sud, Massy, France.
authors: Thierry
authors: T
authors: Lefèvre
authors: Department of Cardiology, CHU Brest, Brest, France.
authors: Martine
authors: M
authors: Gilard
mesh_terms: D058186:Acute Kidney Injury / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D000368:Aged; D000369:Aged, 80 and over; D000740:Anemia / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D001021:Aortic Valve / Q000503:physiopathology; D001024:Aortic Valve Stenosis / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D016009:Chi-Square Distribution; D005260:Female; D005602:France / Q000453:epidemiology; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation / Q000401:mortality; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D012042:Registries; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D006454:Hemoglobins
keywords: acute kidney injury; anemia; severe symptomatic aortic stenosis; transcatheter aortic valve implantation