Journal of Transcatheter Valve Therapies
Online ISSN : 2434-4532
Original Article
Heart Failure Re-admission and Mortality in Chronic Kidney Disease Patients after Transcatheter AorticValve Replacement in Asian Population
Ryo Yamaguchi, Masanori Yamamoto, Tetsuro Shimura, Yuya Adachi, Ai Kagase, Takahiro Tokuda, Satoshi Tsujimoto, Yutaka Koyama, Toshiaki Otsuka, Fumiaki Yashima, Yusuke Watanabe, Norio Tada, Toru Naganuma, Motoharu Araki, Futoshi Yamanaka, Kazuki Mizutani, Minoru Tabata, Hiroshi Ueno, Kensuke Takagi, Shinichi Shirai, Kentaro Hayashida, OCEAN-TAVI Investigators
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Keywords: chronic kidney disease, late adverse cardiorenal events, transcatheter aortic valve replacement
JOURNAL OPEN ACCESS

2022 Volume 4 Issue 1 Pages 23-34

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Abstract

Objective: Chronic kidney disease (CKD) increases the risk of cardiorenal (CR) events such as progression leading to regular hemodialysis, rehospitalization for heart failure (re-HF), and death from cardiac or renal cause (CR death). This study aimed to assess the rates of late adverse CR events among patients with CKD following transcatheter aortic valve replacement (TAVR).

Methods: Data of 2588 patients who underwent TAVR were extracted from the Japanese multicenter registry. The rates of progression leading to regular hemodialysis, re-HF in 1 year, predictive value of re-HF within 1 year, and mortality were assessed according to each CKD category divided into stages 1+2, 3a, 3b, 4, and 5. The advanced CKD was defined as CKD stage ≥3b.

Results: The incidences of hemodialysis after TAVR (n = 20) were increased across the CKD stages (0%, 0.13%, 0.58%, 2.17%, and 20.9%, respectively, p <0.001) and rates of re-HF within 1 year (n = 162) were significantly increased across the CKD stages (3.3%, 5.2%, 8.2%, 10.9%, and 17.0%, respectively, p <0.001). The Cox regression multivariable analysis revealed that the advanced CKD was the independent factor for predicting re-HF within 1 year after TAVR (all p <0.05). The Cox regression multivariable analysis demonstrated that the advanced CKD significantly increased the risk of all-cause death and CR death after TAVR (all p <0.05). The landmark analysis beyond 1 year after TAVR showed similar mortality rates between the patients with non-advanced CKD with re-HF within 1 year and those with advanced CKD without re-HF within 1 year (p = 0.74).

Conclusion: The re-HF and subsequent mortality increase in 1 year as the late CR events after TAVR were significantly increased across the CKD stages. Careful preventative management of re-HF is necessary after TAVR in patients with CKD, especially in the advanced CKD patients.

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© 2022 Japan Transcatheter Valve Therapies

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
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