TY - JOUR
T1 - The impact of chronic kidney disease in women undergoing transcatheter aortic valve replacement
T2 - Analysis from the Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) registry
AU - Bandyopadhyay, Dhrubajyoti
AU - Sartori, Samantha
AU - Baber, Usman
AU - Cao, Davide
AU - Chandiramani, Rishi
AU - Tchétché, Didier
AU - Petronio, Anna Sonia
AU - Mehilli, Julinda
AU - Lefèvre, Thierry
AU - Presbitero, Patrizia
AU - Capranzaro, Piera
AU - Sardella, Gennaro
AU - Van Mieghem, Nicolas M.
AU - Chandrasekhar, Jaya
AU - Dumonteil, Nicholas
AU - Fraccaro, Chiara
AU - Trabattoni, Daniela
AU - Mikhail, Ghada W.
AU - Naber, Christoph
AU - Kini, Annapoorna
AU - Morice, Marie Claude
AU - Claessen, Bimmer E.
AU - Chieffo, Alaide
AU - Mehran, Roxana
N1 - Publisher Copyright: © 2020 Wiley Periodicals, Inc.
PY - 2020/7/1
Y1 - 2020/7/1
N2 - Background: The prevalence of both chronic kidney disease (CKD) and aortic stenosis (AS) increase with age. Although baseline CKD is frequent in patients undergoing transcatheter aortic valve replacement (TAVR), its significance among women is largely unknown. Methods: Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) is a multinational, prospective registry of women undergoing TAVR for severe AS. We included patients with available baseline estimated glomerular filtration rate (eGFR) and completed 1-year follow-up. Patients were categorized into three groups based on their eGFR: No CKD (normal kidney function to stage 2 CKD: eGFR ≥60 ml/min/1.73 m2); (b) mild CKD (stage 3a CKD: eGFR = 45–59 ml/min/1.73 m2); and (c) moderate/severe CKD (stage ≥3b CKD: eGFR <45 ml/min/1.73 m2). All events were adjudicated according to the Valve Academic Research Consortium (VARC)-2 criteria. Result: Out of 852 women undergoing TAVR, 326 (38.3%) had no CKD, 225 (26.4%) had mild CKD, and 301 (35.3%) had moderate/severe CKD. Women with higher stage of CKD at baseline were more likely to have a history of hypertension, diabetes, atrial fibrillation, anemia, chronic lung disease, hemodialysis, prior percutaneous coronary intervention, and pacemaker implantation. After multivariate adjustment, moderate/severe CKD was associated with a greater risk of 1-year VARC-2 safety endpoints [hazard ratio (HR) 1.68, 95% confidence interval (CI): 1.10–2.60], all-cause death (HR 2.00, 95% CI: 1.03–3.90), and composite of death, myocardial infarction, stroke or life-threatening bleeding (HR 1.70, 95% CI: 1.04–2.76). There were no differences in 30-day and 1-year VARC-2 efficacy and 30-day VARC-2 safety outcomes. Conclusion: CKD is associated with substantial and independent risk for mortality and morbidity at 1-year follow-up in women undergoing TAVR.
AB - Background: The prevalence of both chronic kidney disease (CKD) and aortic stenosis (AS) increase with age. Although baseline CKD is frequent in patients undergoing transcatheter aortic valve replacement (TAVR), its significance among women is largely unknown. Methods: Women's INternational Transcatheter Aortic Valve Implantation (WIN-TAVI) is a multinational, prospective registry of women undergoing TAVR for severe AS. We included patients with available baseline estimated glomerular filtration rate (eGFR) and completed 1-year follow-up. Patients were categorized into three groups based on their eGFR: No CKD (normal kidney function to stage 2 CKD: eGFR ≥60 ml/min/1.73 m2); (b) mild CKD (stage 3a CKD: eGFR = 45–59 ml/min/1.73 m2); and (c) moderate/severe CKD (stage ≥3b CKD: eGFR <45 ml/min/1.73 m2). All events were adjudicated according to the Valve Academic Research Consortium (VARC)-2 criteria. Result: Out of 852 women undergoing TAVR, 326 (38.3%) had no CKD, 225 (26.4%) had mild CKD, and 301 (35.3%) had moderate/severe CKD. Women with higher stage of CKD at baseline were more likely to have a history of hypertension, diabetes, atrial fibrillation, anemia, chronic lung disease, hemodialysis, prior percutaneous coronary intervention, and pacemaker implantation. After multivariate adjustment, moderate/severe CKD was associated with a greater risk of 1-year VARC-2 safety endpoints [hazard ratio (HR) 1.68, 95% confidence interval (CI): 1.10–2.60], all-cause death (HR 2.00, 95% CI: 1.03–3.90), and composite of death, myocardial infarction, stroke or life-threatening bleeding (HR 1.70, 95% CI: 1.04–2.76). There were no differences in 30-day and 1-year VARC-2 efficacy and 30-day VARC-2 safety outcomes. Conclusion: CKD is associated with substantial and independent risk for mortality and morbidity at 1-year follow-up in women undergoing TAVR.
KW - WIN-TAVI registry
KW - aortic stenosis
KW - chronic kidney disease
KW - transcatheter aortic valve replacement
UR - http://www.scopus.com/inward/record.url?scp=85078736784&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ccd.28752
DO - https://doi.org/10.1002/ccd.28752
M3 - Article
C2 - 31977142
SN - 1522-1946
VL - 96
SP - 198
EP - 207
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 1
ER -