scholarly journals Contrast-Induced Acute Kidney Injury: Review and Practical Update

2019 ◽  
Vol 13 ◽  
pp. 117954681987868 ◽  
Author(s):  
Ramez Morcos ◽  
Michael Kucharik ◽  
Pirya Bansal ◽  
Haider Al Taii ◽  
Rupesh Manam ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Cardiac Catheterization ◽  
Clinical Management ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Kidney Injury ◽  
Preventive Strategy ◽  
Left Atrial Appendage Closure ◽  
Contrast Administration ◽  
Effective Preventive Strategy

Contrast-induced acute kidney injury (CI-AKI) is an important consideration in patients undergoing cardiac catheterization. There has been a continuous strive to decrease morbidity and improve procedural safety. This review will address the pathophysiology, predictors, and clinical management of CI-AKI with a concise overview of the pathophysiology and a suggested association with left atrial appendage closure. Minimizing contrast administration and intravenous fluid hydration are the cornerstones of an effective preventive strategy. A few adjunctive pharmacotherapies hold promise, but there are no consensus recommendations on prophylactic therapies.

scholarly journals CRT-700.43 Incidence, Predictors and Prognostic Value of Acute Kidney Injury Among Patients Undergoing Left Atrial Appendage Closure

2018 ◽  
Vol 11 (4) ◽  
pp. S60-S61 ◽  
Author(s):  
Luis Nombela-Franco ◽  
Josep Rodes-Cabau ◽  
Ignacio Cruz-Gonzalez ◽  
Xavi Freixa ◽  
Luis Asmarats ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Left Atrial ◽  
Prognostic Value ◽  
Left Atrial Appendage ◽  
Kidney Injury ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure

scholarly journals Incidence, Predictors, and Prognostic Value of Acute Kidney Injury Among Patients Undergoing Left Atrial Appendage Closure

2018 ◽  
Vol 11 (11) ◽  
pp. 1074-1083 ◽  
Author(s):  
Luis Nombela-Franco ◽  
Josep Rodés-Cabau ◽  
Ignacio Cruz-Gonzalez ◽  
Xavier Freixa ◽  
Luis Asmarats ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Left Atrial ◽  
Prognostic Value ◽  
Left Atrial Appendage ◽  
Kidney Injury ◽  
Atrial Appendage ◽  
Left Atrial Appendage Closure

Comorbidity burden in patients undergoing left atrial appendage closure

Heart ◽  
2020 ◽  
pp. heartjnl-2020-317741
Author(s):  
Shubrandu Sanjoy ◽  
Yun-Hee Choi ◽  
David Holmes ◽  
Howard Herrman ◽  
Juan Terre ◽  
...  
Keyword(s):  
Left Atrial ◽  
Left Atrial Appendage ◽  
Vascular Complications ◽  
Kidney Injury ◽  
Atrial Appendage ◽  
Bleeding Complications ◽  
Cardiac Complications ◽  
Left Atrial Appendage Closure ◽  
Comorbidity Burden ◽  
The Mean

ObjectiveTo estimate the risk of in-hospital complications after left atrial appendage closure (LAAC) in relationship with comorbidity burden.MethodsCohort-based observational study using the US National Inpatient Sample database, 1 October 2015 to 31 December 2017. The main outcome of interest was the occurrence of in-hospital major adverse events (MAE) defined as the composite of bleeding complications, acute kidney injury, vascular complications, cardiac complications and postprocedural stroke. Comorbidity burden and thromboembolic risk were assessed by the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Score (ECS) and CHA2DS2-VASc score. MAE were identified using International Classification of Diseases, Tenth Revision, Clinical Modification codes. The associations of comorbidity with in-hospital MAE were evaluated using logistic regression models.ResultsA total of 3294 hospitalisations were identified, among these, the mean age was 75.7±8.2 years, 60% were male and 86% whites. The mean CHA2DS2-VASc score was 4.3±1.5 and 29.5% of the patients had previous stroke or transient ischaemic attack. The mean CCI and ECS were 2.2±1.9 and 9.7±5.8, respectively. The overall composite rate of in-hospital MAE after LAAC was 4.6%. Females and non-whites had about 1.5 higher odds of in-hospital AEs as well participants with higher CCI (adjusted OR (aOR): 1.19, 95% CI: 1.13 to 1.24, p<0.001), ECS (aOR: 1.06, 95% CI: 1.05 to 1.08, p<0.001) and CHA2DS2-VASc score (aOR: 1.08, 95% CI: 1.02 to 1.15, p=0.01) were significantly associated with in-hospital MAE.ConclusionIn this large cohort of LAAC patients, the majority of them had significant comorbidity burden. In-hospital MAE occurred in 4.6% and female patients, non-whites and those with higher burden of comorbidities were at higher risk of in-hospital MAE after LAAC.

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