Chronic Kidney Disease and Outcomes after Transcatheter Aortic Valve Replacement
Presenter
Aamir Twing, MD, University of Illinois Chicago, Chicago, IL
Aamir Twing, MD1, Gabriel E Marrero-Rivera, M.D.2, Sanket Gokhale, M.D.2, Brody Slostad, MD3, Nicole A Cho3, Helena Dickens, BS2, Fatema Nomani2, Mayank Kansal, MD3, Elliott Michael Groves, M.D.4 and Adhir R. Shroff, MD, FSCAI2, (1)University of Illinois Chicago, Chicago, IL, (2)University of Illinois at Chicago, Chicago, IL, (3)University Of Illinois At Chicago, Chicago, IL, (4)Palo Alto Medical Foundation, Burlingame, CA
Keywords: Structural Heart Disease (SHD) and TAVI/TAVR/Aortic Valve
Background
Chronic kidney disease (CKD) is known to accelerate the progression of aortic stenosis (AS) and portends adverse outcomes in patients treated with surgical valve replacement. Outcomes in CKD patients after transcatheter aortic valve replacement (TAVR) have been less studied. The purpose of this study is to examine outcomes after TAVR in CKD patients.
Methods
Retrospective electronic medical record review from March 2018-June 2020 at the University of Illinois Chicago identified TAVR patients, who were included if they followed-up within 6 months of procedure. Patients were stratified into 4 classes by baseline GFR (mL/min): >90, 60-89, 30-59, and <30 with the latter 3 groups defining CKD patients. Outcomes were compared among these 4 groups using chi-square analysis and included composite 6-month MACE (all-cause mortality, MI, or CVA) and 30-day re-hospitalization.
Results
We included 116 patients in the analysis. Of these, 76% had CKD (average age 76±9 years, 79% male, 44% black). There were no major differences in demographics or baseline comorbidities compared to non-CKD patients. At 6 months, CKD patients were more likely to experience MACE compared to non-CKD patients (p=0.045, Fig. 1). CKD patients were also more likely to be re-hospitalized within 30 days of TAVR (p=0.003, Fig. 1).
Conclusions
Our results demonstrate that CKD portends adverse outcomes after TAVR with CKD patients experiencing an increased risk of 6-month MACE and 30-day re-hospitalization. Decreasing GFR correlated with higher MACE and re-hospitalization rates.
