Acute kidney injury after transcatheter aortic valve implantation with self-expanding CoreValve prosthesis: results from a large multicentre Italian research project.

Aims: Transcatheter aortic valve implantation (TAVI) can be associated with varying degrees of new renal impairment. The aim of this multicentre analysis was to determine the impact and predictors of periprocedural acute kidney injury (AKI) on prognosis after TAVI. Methods and results: From the ClinicalService® (a nation-based data repository and medical care project) dataset, 1,157 patients with severe aortic stenosis treated with the third-generation CoreValve prosthesis in seven Italian sites, and with creatinine data available at baseline and during the post-TAVI in-hospital course, were included in this analysis. All outcomes were defined according to the VARC criteria. Overall, AKI occurred in 231 (20.0%): 15.4% stage 1, 2.7% stage 2, and 1.9% stage 3. Compared to patients without AKI, patients who suffered post-procedural AKI had significantly higher three-year all-cause mortality (31% vs. 12%; adjusted HR: 2.09; 95% CI: 1.52-2.87, p<0.001) and cardiovascular mortality (14% vs. 6%; adjusted HR: 2.28; 95% CI: 1.41-3.71, p=0.001). No significant differences in terms of stroke, spontaneous MI, and bleeding were reported. Female gender (adjusted OR: 1.37, 95% CI: 1.01-1.87; p=0.045), baseline renal insufficiency (adjusted OR: 11.02, 95% CI: 5.12-23.73; p