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May 1, 2022Journal of the Society for Cardiovascular Angiography & InterventionsOpen Access

Renal Function–Based Contrast Threshold Predicts Kidney Injury in Transcatheter Aortic Valve Replacement

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Key result

Higher contrast volume to eGFR ratio during TAVR predicts AKI.

  • 95% CI 1.38-2.03
  • P<0.0001

Why the study?

The role of contrast volume in the context of baseline renal function as a predictor of acute kidney injury is less well described in patients undergoing TAVR.

Does the ratio of contrast volume to estimated glomerular filtration rate predict acute kidney injury in patients undergoing transcatheter aortic valve replacement?

Population

Patients from the Michigan TAVR registry between January 2016 and December 2019

Comparison

Ratio of contrast volume to estimated glomerular filtration rate

Design

Registry-based cohort study

Authors

SGSarah K. GualanoMSMilan SethHGHitinder S. Gurm

Discussion

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Member takes

Overview

May support contrast minimization in TAVR to lower AKI risk; leaves open whether ratio-guided interventions improve outcomes.

Study Design

Type

Cohort

Multicenter

Yes

Structured PICO

Does the ratio of contrast volume to estimated glomerular filtration rate predict acute kidney injury in patients undergoing transcatheter aortic valve replacement?

P
Population
Patients undergoing transcatheter aortic valve replacement from the Michigan TAVR registry between 2016 and 2019.
E
Exposure
Contrast volume (CV) to estimated glomerular filtration rate (eGFR) ratio thresholds (>2× and >3× eGFR)
O
Outcome
Acute kidney injury (AKI) defined using Valve Academic Research Consortium 2 definitionssafety

Main Result

p-value: p=<0.0001

The ratio of contrast volume to eGFR is a robust predictor of acute kidney injury following TAVR, suggesting thresholds of >2× and >3× eGFR should be incorporated into procedural planning.

Cite This Study

Gualano et al. (2022) conducted a cohort in Transcatheter aortic valve replacement (TAVR). Ratio of contrast volume to estimated glomerular filtration rate (CV/eGFR) was evaluated on Acute kidney injury (AKI) (95% CI 1.38-2.03, p=<0.0001). The ratio of contrast volume to estimated glomerular filtration rate during TAVR significantly predicted acute kidney injury (95% CI 1.38-2.03; P<0.0001).

synapsesocial.com/papers/6aa3d57bd5ccfe0ebfb7258ehttps://doi.org/10.1016/j.jscai.2022.100038
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Contrast Volume-to-Estimated Glomerular Filtration Rate Ratio as a Predictor of Short-Term Outcomes Following Transcatheter Aortic Valve Implantation2024
  2. 2Predicting Acute Kidney Injury following Transcatheter Aortic Valve Replacement2017 · 4 citations
  3. 3Zero To Hero? Reducing The Rate of Acute Kidney Injury in Transcatheter Aortic Valve Replacement: The Low Contrast Approach2023
  4. 4Performance of Prediction Models for Contrast-Induced Acute Kidney Injury after Transcutaneous Aortic Valve Replacement2021 · 5 citations
  5. 5Zero to Hero? Reducing the Rate of Acute Kidney Injury in Transcatheter Aortic Valve Replacement: The Low Contrast Approach2023 · 2 citations