Baseline NT-proBNP predicts acute kidney injury following transcatheter aortic valve implantation

Kristina Eckrich; Norman Mangner; Sandra Erbs; Felix Woitek; Philipp Kiefer; Florian Schlotter; Georg Stachel; Sergey Leontyev; David Holzhey; Michael A Borger; Axel Linke; Stephan Haussig

doi:10.1016/j.carrev.2024.03.027

Baseline NT-proBNP predicts acute kidney injury following transcatheter aortic valve implantation

Cardiovasc Revasc Med. 2024 Mar 30:S1553-8389(24)00115-5. doi: 10.1016/j.carrev.2024.03.027. Online ahead of print.

Authors

Affiliations

¹ Helios Park-Klinikum Leipzig, Department of Internal Medicine and Cardiology, Leipzig, Germany.
² Herzzentrum Dresden, University Clinic, Technische Universitaet Dresden, Department of Internal Medicine and Cardiology, Dresden, Germany.
³ University of Leipzig - Heart Center, Department of Internal Medicine and Cardiology, Leipzig, Germany.
⁴ University of Leipzig - Heart Center, Department of Cardiac Surgery, Leipzig, Germany.
⁵ Klinik und Poliklinik für Kardiologie, Leipzig University Clinic, Leipzig, Germany.
⁶ Helios Heart Center Wuppertal, Department of Cardiac Surgery, Witten/Herdecke University, Wuppertal, Germany.
⁷ Herzzentrum Dresden, University Clinic, Technische Universitaet Dresden, Department of Internal Medicine and Cardiology, Dresden, Germany. Electronic address: stephan.haussig@tu-dresden.de.

PMID: 38599917
DOI: 10.1016/j.carrev.2024.03.027

Abstract

Background/purpose: Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) increases morbidity and mortality. Our study aimed to investigate the role of baseline N-terminal pro B-type natriuretic peptide (NT-proBNP) as a predictor of AKI following TAVI.

Methods: All consecutive TAVI patients were included in the analysis, except patients with dialysis and those with a GFR < 15 ml/min/1.73 m² at baseline. Rates of AKI after TAVI were assessed according to the updated valve academic research consortium definitions using AKIN classification in three stages. NT-proBNP was measured at baseline. One-year mortality rates were assessed.

Results: We included 1973 patients treated with TAVI between January 2006 and December 2016. Median [IQR] age was 81.0 [77.0;84.0] years, the STS score was 6.2 [3.9;9.0], and the logEuroScore was 14.5 [9.0;23.0]. 30-day and one-year mortality was 5.1 % and 16.1 % for all patients, respectively. Multivariate analysis revealed that patients with NT-proBNP levels higher than two times above the upper level of normal (ULN) had an increased risk for AKI after TAVI compared to patients with NT-proBNP levels < 2× ULN (OR 1.40 [1.03-1.91]).

Conclusions: Routine assessment of baseline NT-proBNP levels might be an additional tool to identify patients at increased risk for AKI after TAVI.

Keywords: AKI; NT-proBNP; TAVI.