Key result
Postoperative acute kidney injury after TAVI increased early all-cause mortality and 1-year all-cause mortality.
Why the study?
Does postoperative acute kidney injury worsen clinical outcomes in patients undergoing transcatheter aortic valve implantation?
Meta-Analysis (n=5,971)
Does postoperative acute kidney injury worsen clinical outcomes in patients undergoing transcatheter aortic valve implantation?
Answers are grounded in this paper and cite their sources.
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.
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.
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Gargiulo et al. (2015) 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 increased early all-cause mortality and 1-year all-cause mortality.
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