title: Predictive Value of the Mehran Score for Contrast-Induced Nephropathy after Transcatheter Aortic Valve Implantation in Patients with Aortic Stenosis.
abstract: OBJECTIVE
  The Mehran risk score (MS) was adopted to predict the development of contrast-induced nephropathy (CIN) and includes clinical and procedural variables. In this study, we aimed to evaluate the value of MS in the prediction of CIN development after transcatheter aortic valve implantation (TAVI).
  
  
  METHODS
  Ninety-three patients (47 females; mean age, 77.2 ± 7.6 years) who underwent aortic valve replacement with TAVI for severe aortic stenosis in our center between June 2013 and November 2014 were included in the study. Patients were categorized into four risk groups based on MS: low (≤5), moderate (6-10), high (11-15), and very high (≥16).
  
  
  RESULTS
  CIN was recorded in 24 patients after TAVI (25.8%). The amount of contrast medium was significantly higher in the CIN+ group (p = 0.029), and total mortality was higher in the CIN+ group than in the CIN- group (20.1 vs. 2.9%, respectively; p = 0.024). In univariate analysis, diabetes mellitus, coronary artery disease, ejection fraction, baseline creatinine, baseline glomerular filtration rate, contrast medium volume, and MS were found to be significant risk factors for CIN (p < 0.05 for all). The receiver operating characteristic analysis of the significant variables in multivariate regression analysis revealed that the cutoff MS to predict the development of CIN was 13.0 (area under the curve, 0.654; 95% confidence interval, 0.495-0.758; sensitivity, 62%; specificity, 68%).
  
  
  CONCLUSIONS
  MS is a predictor of CIN development after TAVI. We think that the use of MS in clinical practice may decrease renal complications after TAVI.
authors.affiliation: Department of Cardiology, Sifa University Faculty of Medicine, Izmir, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Zungur
authors.affiliation: Department of Cardiology, Sifa University Faculty of Medicine, Izmir, Turkey.
authors.forename: Ilker
authors.initials: I
authors.lastname: Gul
authors.affiliation: Department of Cardiology, Sifa University Faculty of Medicine, Izmir, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tastan
authors.affiliation: Department of Anesthesiology and Reanimation, Sifa University Faculty of Medicine, Izmir, Turkey.
authors.forename: Ertan
authors.initials: E
authors.lastname: Damar
authors.affiliation: Department of Cardiology, Sifa University Faculty of Medicine, Izmir, Turkey.
authors.forename: Talat
authors.initials: T
authors.lastname: Tavli
keywords: Contrast-induced nephropathy; Mehran risk score; Transcatheter aortic valve implantation