Acute Kidney Injury Following Tricuspid Transcatheter Edge-to-Edge Repair

JACC Cardiovasc Interv. 2022 Oct 10;15(19):1936-1945. doi: 10.1016/j.jcin.2022.07.018. Epub 2022 Aug 22.

Abstract

Background: Little is known about the incidence and clinical relevance of postprocedural acute kidney injury (AKI) in patients undergoing transcatheter edge-to-edge repair (TEER) for tricuspid regurgitation (TR).

Objectives: The aim of this study was to investigate the prognostic impact of postprocedural AKI following TEER for TR.

Methods: Two hundred sixty-eight patients who underwent TEER for TR at 2 centers were retrospectively analyzed. Postprocedural AKI was defined as an increase in serum creatinine of ≥0.3 mg/dL within 48 hours or ≥50% within 7 days after the procedure compared with baseline. The association between AKI and the composite outcome, consisting of all-cause mortality and rehospitalization for heart failure within 1 year after the procedure, was determined.

Results: The mean age of the patients was 79.0 ± 6.8 years, and 43.3% were men. Postprocedural AKI occurred in 42 patients (15.7%). Age, male sex, an estimated glomerular filtration rate of <60 mL/min/1.73 m2, and absence of procedural success were associated with the occurrence of AKI. Patients with AKI had a higher incidence of in-hospital mortality than those without AKI (9.5% vs 0.9%; P = 0.006). Moreover, AKI was associated with the incidence of the composite outcome within 1 year after TEER for TR (adjusted HR: 2.39; 95% CI: 1.45-3.94; P = 0.001).

Conclusions: Postprocedural AKI occurred in 15.7% of patients undergoing TEER for TR, despite the absence of iodinated contrast agents, which was associated with worse clinical outcomes. These findings highlight the clinical impact of AKI following TEER for TR and should help in identifying patients at high risk for AKI.

Keywords: acute kidney injury; tricuspid regurgitation; tricuspid transcatheter edge-to-edge repair.

MeSH terms

  • Acute Kidney Injury* / diagnosis
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / etiology
  • Aged
  • Aged, 80 and over
  • Cardiac Catheterization / adverse effects
  • Contrast Media / adverse effects
  • Creatinine
  • Female
  • Heart Valve Prosthesis Implantation* / adverse effects
  • Humans
  • Male
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Tricuspid Valve Insufficiency*

Substances

  • Contrast Media
  • Creatinine