An echocardiographic nomogram successfully predicted the risk of acute kidney injury following TAVI, yielding an AUC of 0.888 in the training set and 0.761 in the validation set.
Cohort (n=202)
No
Can a nomogram incorporating echocardiographic and clinical variables accurately predict the risk of acute kidney injury following TAVI?
A novel nomogram incorporating echocardiographic and clinical variables shows good predictive accuracy for acute kidney injury following TAVI, potentially aiding in personalized risk assessment.
Effect estimate: AUC 0.888 (95% CI 0.813-0.963)
Absolute Event Rate: 19.86% vs 19.67%
p-value: p=<0.05
Objective The purpose of this study was to develop and evaluate a nomogram for predicting the risk of acute kidney injury (AKI) following TAVI, as well as to identify which echocardiographic characteristics could do so. Methods We retrospectively analyzed 202 consecutive TAVI patients treated from January 2019 to December 2023. 141 patients were randomly assigned to the training set for model construction and 61 to the validation set for testing in a 7:3 split. Sequential univariate and multivariate logistic regression analyses pinpointed independent AKI predictors, which were then used to build a nomogram. We evaluated the model’s efficacy by generating ROC and calibration curves. Additionally, the validation set and decision curve analysis (DCA) were used to further evaluate the model’s clinical value and prediction accuracy. Results Twelve patients (19.67%) in the validation group and 28 patients (19.86%) in the training set experienced AKI following surgery. The regression analysis identified several independent predictors of AKI, including echocardiographic abnormalities (left atrial enlargement, increased LVEDD, and moderate‐to‐severe TR), pre‐existing diabetes, elevated preoperative levels of blood urea nitrogen and NT‐proBNP, and higher intraoperative contrast volume (all p < 0.05). Good calibration and discrimination were observed for the nomogram in both the training and validation sets, yielding AUCs of 0.888 (95% CI: 0.813–0.963) and 0.761 (95% CI: 0.544–0.978), respectively. Respective specificity and sensitivity values were 0.835 and 0.800 (training set), and 0.735 and 0.625 (validation set). Conclusion The echocardiographic nomogram helps predict post‐TAVI AKI risk, offering valuable reference for personalized treatment planning. Nevertheless, its generalizability requires further confirmation through large‐sample, multicenter studies.
Liu et al. (Thu,) conducted a cohort in Acute Kidney Injury following TAVI (n=202). Predictive nomogram was evaluated on Acute kidney injury (AKI) following TAVI (AUC 0.888, 95% CI 0.813-0.963, p=<0.05). An echocardiographic nomogram successfully predicted the risk of acute kidney injury following TAVI, yielding an AUC of 0.888 in the training set and 0.761 in the validation set.