title: Impact of postoperative acute kidney injury on clinical outcomes after transcatheter aortic valve implantation: A meta-analysis of 5,971 patients.
abstract: BACKGROUND
  There is conflicting evidence on the safety and efficacy of transcatheter aortic valve implantation (TAVI) in patients with postoperative acute kidney injury (AKI). Therefore, we conducted a meta-analysis on the impact of AKI on clinical outcomes after TAVI.
  
  
  RESULTS
  Twenty-four studies including 5,971 patients were analyzed. The mean incidence of AKI in this population was 22.1% ± 11.2. Postoperative AKI significantly increased early (odds ratio [OR] 5.09; 95% confidence interval [CI], 4.03-6.43 and OR 6.14; 95% CI, 3.26-11.55) and 1-year (OR 3.27; 95% CI, 2.42-4.42 and OR 1.93; 95% CI, 1.38-2.71) all-cause and cardiovascular mortality respectively, but also early myocardial infarction (OR 3.30; 95% CI, 1.44-7.57), life-threatening bleeding (OR 2.90; 95% CI, 1.67-5.05), need for transfusion (OR 2.42; 95% CI, 1.96-2.99), and dialysis (OR 14.35; 95% CI, 6.21-33.20), with a non-significant increase of stroke (OR 1.66; 95% CI, 0.94-2.95), hospitalization (mean difference [MD] 1.73; 95% CI, -0.31 to 3.77) and contrast medium received (MD 4.74; 95% CI, -2.33 to 11.81).
  
  
  CONCLUSIONS
  Postoperative AKI seems to significantly worsen TAVI prognosis. The results of the present meta-analysis should be considered hypothesis-generating and future studies on risk stratification, prevention, and postoperative management are needed.
authors: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Giuseppe
authors: G
authors: Gargiulo
authors: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Anna
authors: A
authors: Sannino
authors: Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.|Excellence through Newest Advances (ETNA) Foundation, Catania, Italy.
authors: Davide
authors: D
authors: Capodanno
authors: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Cinzia
authors: C
authors: Perrino
authors: Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.|Excellence through Newest Advances (ETNA) Foundation, Catania, Italy.
authors: Piera
authors: P
authors: Capranzano
authors: Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors: Marco
authors: M
authors: Barbanti
authors: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Eugenio
authors: E
authors: Stabile
authors: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Bruno
authors: B
authors: Trimarco
authors: Division of Cardiology, Ferrarotto Hospital, University of Catania, Catania, Italy.|Excellence through Newest Advances (ETNA) Foundation, Catania, Italy.
authors: Corrado
authors: C
authors: Tamburino
authors: Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy.
authors: Giovanni
authors: G
authors: Esposito
mesh_terms: D058186:Acute Kidney Injury / Q000209:etiology* / Q000401:mortality; D001024:Aortic Valve Stenosis / Q000401:mortality / Q000628:therapy*; D006801:Humans; D011379:Prognosis; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects* / Q000401:mortality
keywords: acute kidney injury; prognosis; severe aortic stenosis; transcatheter aortic valve implantation