Impact of Sex on the Risk to Develop Contrast-Induced Nephropathy after Transcatheter Aortic Valve Implantation

Author(s):  
Navid Madershahian ◽  
Maximilian Scherner ◽  
Tanja Rudolph ◽  
Ingo Slottosch ◽  
Franziska Grundmann ◽  
...  
2014 ◽  
Vol 5 (1) ◽  
pp. 31-39 ◽  
Author(s):  
Ilker Gul ◽  
Mustafa Zungur ◽  
Ahmet Tastan ◽  
Faik Fevzi Okur ◽  
Ertan Damar ◽  
...  

Background/Aim: Transcatheter aortic valve implantation (TAVI) is a method which is increasingly applied in severe aortic stenosis treatment. The development of contrast-induced nephropathy (CIN) after TAVI increases morbidity and mortality rates. Within the scope of this study, the importance of the contrast medium volume to glomerular filtration rate (CV/GFR) ratio in determining the development of CIN and the amount of CV that could be applied was evaluated. Methods: Seventy-two patients (aged 78.6 ± 11.6 years; 38 females) who underwent aortic valve replacement with the TAVI method between June 2013 and August 2014 were included in the study. CIN was defined as an absolute increase in serum creatinine of >0.5 mg/dl or a relative increase of >25% within 48-72 h after TAVI. CIN+ and CIN- patients were classified into two groups. The χ2 test, t test, Mann-Whitney U test, ROC analysis, and univariate and multivariate regression analyses were applied for statistical analyses. Results: CIN was detected in 16 patients (22%) in our study. Baseline creatinine, baseline GFR, the Mehran risk score, CV, and the CV/GFR ratio were determined as the predictive factors of CIN development. A CV/GFR ratio of 3.9 was specified to predict CIN development with 71% sensitivity and 80% specificity. Conclusion: After TAVI, CIN may develop due to various reasons. In patients to whom TAVI was applied, the CV/GFR ratio may be a guideline helping to prevent the development of renal pathologies. The amount of contrast medium that can be given to a patient can be calculated in terms of baseline GFR.


2017 ◽  
Vol 45 (3) ◽  
pp. 242-246
Author(s):  
D. L. Kranin ◽  
V. V. Stets ◽  
O. R. Pestovskaya ◽  
E. P. Dunaev ◽  
D. A. Nazarov ◽  
...  

2016 ◽  
Vol 6 (4) ◽  
pp. 279-288 ◽  
Author(s):  
Mustafa Zungur ◽  
Ilker Gul ◽  
Ahmet Tastan ◽  
Ertan Damar ◽  
Talat Tavli

Background/Aims: The Mehran risk score (MS) was adopted to predict the development of contrast-induced nephropathy (CIN) and includes clinical and procedural variables. In this study, we aimed to evaluate the value of MS in the prediction of CIN development after transcatheter aortic valve implantation (TAVI). Methods: Ninety-three patients (47 females; mean age, 77.2 ± 7.6 years) who underwent aortic valve replacement with TAVI for severe aortic stenosis in our center between June 2013 and November 2014 were included in the study. Patients were categorized into four risk groups based on MS: low (≤5), moderate (6-10), high (11-15), and very high (≥16). Results: CIN was recorded in 24 patients after TAVI (25.8%). The amount of contrast medium was significantly higher in the CIN+ group (p = 0.029), and total mortality was higher in the CIN+ group than in the CIN- group (20.1 vs. 2.9%, respectively; p = 0.024). In univariate analysis, diabetes mellitus, coronary artery disease, ejection fraction, baseline creatinine, baseline glomerular filtration rate, contrast medium volume, and MS were found to be significant risk factors for CIN (p < 0.05 for all). The receiver operating characteristic analysis of the significant variables in multivariate regression analysis revealed that the cutoff MS to predict the development of CIN was 13.0 (area under the curve, 0.654; 95% confidence interval, 0.495-0.758; sensitivity, 62%; specificity, 68%). Conclusion: MS is a predictor of CIN development after TAVI. We think that the use of MS in clinical practice may decrease renal complications after TAVI.


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