Key result
The ACEF score was an independent predictor of acute kidney injury following transcatheter aortic valve implantation (OR 22.91), with a score ≥1.36 predicting AKI with 96.6% sensitivity and 58.8% specificity.
Why the study?
Acute kidney injury is a common complication after TAVI associated with worse outcomes, and whether the simple ACEF score can predict AKI in this population was unknown.
Does the ACEF score predict the development of acute kidney injury in patients undergoing transcatheter aortic valve implantation?
Cohort (n=173)
No
Does the ACEF score predict the development of acute kidney injury in patients undergoing transcatheter aortic valve implantation?
Odds Ratio: 22.91 (95% CI 5.1–102.84)
p-value: p=<0.001
The ACEF score is a simple and objective tool that independently predicts the development of acute kidney injury following transcatheter aortic valve implantation.
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is an effective, less invasive treatment alternative for symptomatic severe aortic stenosis (AS). Acute kidney injury (AKI) following TAVI is a common complication and is associated with worse outcomes. The age, creatinine, ejection fraction (ACEF) score is a simple scoring method, including only three parameters: age, creatinine, and ejection fraction (EF). The score was well established in predicting AKI after coronary interventions. AIMS: We aimed to evaluate whether this simple scoring method, ACEF, may predict a development of AKI in patients who underwent TAVI. METHODS: A total of 173 consecutive patients with symptomatic severe AS who underwent TAVI were included retrospectively. The primary endpoint of the study was the development of AKI. Study population was divided into two groups according to the presence of AKI. The ACEF score was calculated with the formula: age/EF + 1 (if baseline creatinine >2 mg/dl). RESULTS: Twenty-nine patients developed AKI. The median (interquartile range) ACEF score was 1.36 (1.20-1.58). The ACEF score was found to be an independent predictor of AKI (P <0.001). The ACEF score ≥1.36 predicted AKI development with a sensitivity of 96.6% and specificity of 58.8%. Moreover, hypertension, hemoglobin levels, contrast volume, and aortic valve area (AVA) were found to be independent predictors of AKI. CONCLUSIONS: Our study revealed that the ACEF score was an independent predictor of AKI. A simple and objective score might be very useful in predicting AKI development in patients undergoing TAVI.
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Uygur et al. (2021) conducted a cohort in Symptomatic severe aortic stenosis (n=173). ACEF score was evaluated on Development of acute kidney injury (AKI) ≤72 hours postprocedure (OR 22.91, 95% CI 5.10-102.84, p=<0.001). The ACEF score was an independent predictor of acute kidney injury following transcatheter aortic valve implantation (OR 22.91), with a score ≥1.36 predicting AKI with 96.6% sensitivity and 58.8% specificity.
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