Postoperative acute kidney injury after TAVI significantly increased early all-cause mortality (OR 5.09; 95% CI 4.03-6.43) and 1-year all-cause mortality (OR 3.27; 95% CI 2.42-4.42).
Meta-Analysis (n=5,971)
Does postoperative acute kidney injury worsen clinical outcomes in patients undergoing transcatheter aortic valve implantation?
Postoperative acute kidney injury after TAVI is associated with significantly increased early and 1-year mortality, as well as increased risk of MI, bleeding, and dialysis.
Effect estimate: OR 5.09 (95% CI 4.03-6.43)
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. METHODS AND 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.
Gargiulo et al. (Fri,) conducted a meta-analysis in Transcatheter aortic valve implantation (TAVI) (n=5,971). Postoperative acute kidney injury vs. No postoperative acute kidney injury was evaluated on Early all-cause mortality (OR 5.09, 95% CI 4.03-6.43). Postoperative acute kidney injury after TAVI significantly increased early all-cause mortality (OR 5.09; 95% CI 4.03-6.43) and 1-year all-cause mortality (OR 3.27; 95% CI 2.42-4.42).