Can Acute Kidney Injury After Transcatheter Aortic Valve Replacement Alone Predict Poor Prognosis in Diabetic Patients?

Abstract

Aim: Transcatheter aortic valve implantation (TAVI) has become a well-recognized treatment option for patients with symptomatic severe aortic stenosis (AS) who are deemed to have a higher risk for surgical intervention. Due to underlying comorbidities, acute kidney injury (AKI) continues to be a common complication, especially in patients with diabetes mellitus after TAVR. The aim of this study is to evaluate the effect of postoperative AKI development in diabetic patients undergoing TAVR on the development of mortality and major adverse cardiac events (MACE) in these patients. Material and Method: A total of 141 patients who underwent TAVR between January 2015 and January 2020 were grouped according to whether they developed AKI and whether they had MACE. MACE and 5-year mortality status were compared according to whether the patients developed AKI. Results: A total of 35 patients were observed to develop AKI (24.8%). Additionally, MACE was observed in 36 patients (25.5%). Five-year mortality rates (42.9% vs. 15.1%; p = 0.002) and MACE rates (54.3% vs. 16%; p < 0.001) were significantly higher in the AKI group. Univariate and multivariate logistic regression analyses identified AKI as a significant independent predictor of MACE development, regardless of other associated parameters (OR = 3.92, 95% CI: 1.28–12.02; p = 0.017). Conclusion: The most important result obtained in this study is that AKI development in diabetic patients who underwent TAVR with the diagnosis of advanced aortic stenosis has an effect on the development of MACE and long-term mortality independently of other parameters.