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Performance of Prediction Models for Contrast-Induced Acute Kidney Injury after Transcutaneous Aortic Valve Replacement.
Rosa, Vitor E E; Campos, Carlos M; Bacelar, Antonio; Abizaid, Alexandre A C; Mangione, José A; Lemos, Pedro A; Esteves, Vinicius; Caramori, Paulo; Sampaio, Roney O; Tarasoutchi, Flávio; Mehran, Roxana; Brito, Fabio S.
Afiliación
  • Rosa VEE; Hospital Israelita Albert Einstein, São Paulo, Brazil, vitoremer@yahoo.com.br.
  • Campos CM; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil, vitoremer@yahoo.com.br.
  • Bacelar A; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
  • Abizaid AAC; Instituto Prevent Senior, São Paulo, Brazil.
  • Mangione JA; Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Lemos PA; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
  • Esteves V; Hospital Beneficiência Portuguesa, São Paulo, Brazil.
  • Caramori P; Hospital Israelita Albert Einstein, São Paulo, Brazil.
  • Sampaio RO; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
  • Tarasoutchi F; Hospital Brasil - Rede D'Or, São Paulo, Brazil.
  • Mehran R; Hospital São Lucas - PUCRS, Porto Alegre, Brazil.
  • Brito FS; Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Cardiorenal Med ; 11(4): 166-173, 2021.
Article en En | MEDLINE | ID: mdl-34261063
BACKGROUND: Acute kidney injury (AKI) has shown to adversely affect outcomes in patients undergoing transcutaneous aortic valve replacement (TAVR), and its correct risk estimation may interfere in procedural planning and strategies. The aim of the study was to test and compare 6 scores in predicting AKI after TAVR. METHODS: We tested 6 scores (the contrast material limit score, volume-to-creatinine clearance ratio, ACEF, CR4EATME3AD3, Mehran model A, and Mehran model B) in a total of 559 consecutive patients included in the Brazilian TAVR registry. RESULTS: All scores had a poor accuracy and calibration to predict the occurrence of AKI grade 1 or 2. All scores improved the accuracy of AKI risk prediction when stratified for AKI grade 2/3 and AKI grade 3 for all scores. The CR4EATME3AD3 was the best predictor of AKI stage 2/3 (AUC: 0.62; OR: 1.12; 95% CI 1.01-1.26; p = 0.04) and AKI stage 3 (AUC: 0.64; OR: 1.16; 95% CI 1.02-1.32; p = 0.02). Mehran models A and B were both good models for AKI stage 3 (AUC: 0.63; OR: 1.10; 95% CI 1.01-1.22; p = 0.05; and AUC: 0.62; OR: 1.10; 95% CI 1.00-1.21; p = 0.05, respectively). CONCLUSIONS: None of the current models demonstrated validity in detecting AKI when its lower grades were evaluated. CR4EATME3AD3 was the best score in predicting moderate to severe AKI after TAVR. These findings suggest that contrast-induced AKI may not be the only factor related to kidney injury after TAVR.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Prótesis Valvulares Cardíacas / Lesión Renal Aguda Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Cardiorenal Med Año: 2021 Tipo del documento: Article Pais de publicación: Suiza
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Estenosis de la Válvula Aórtica / Prótesis Valvulares Cardíacas / Lesión Renal Aguda Tipo de estudio: Diagnostic_studies / Etiology_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Cardiorenal Med Año: 2021 Tipo del documento: Article Pais de publicación: Suiza