Demographic, Clinical and Laboratory Predictors of Contrast Induced Nephropathy in Patients with Severe Aortic Stenosis Undergoing TAVR.

Introduction:

Contrast induced nephropathy (CIN) is a well-known complication of the TAVR procedure, and is associated with a longer hospital stay and higher peri- procedural mortality.

The prognostic factors for developing CIN in patients undergoing coronary interventions are incorporated in the Mehran`s score. However, TAVR patient population is different from PCI population and Mehran`s score could not be applicable. Thus, we aimed to determine the predictors of CIN in patients undergoing TAVR.

Methods:

In this retrospective study we included all patient who underwent TAVR for severe aortic stenosis at an academic institution between January 1 2018 and December 31 2019. Four patients on chronic dialysis were excluded from the analysis.

We performed a logistic regression analysis of age, gender, weight, body surface area, history of hypertension, diabetes mellitus, hyperlipidaemia, congestive heart failure, pre procedure levels of haemoglobin, haematocrit, logₑBNP, GFR less than 50 ml/min and delivered contrast volume as a possible predictor of CIN.

Results:

Total of 118 patients were included in this study with 12 patients (10%) developed CIN.

GFR less than 50 ml/min and contrast volume were found to be significant risk factors for development of CIN (OR=13, p=0.02 for GFR less than 50, OR=1.013, p=0.019 for contrast volume). None of the well-known predictors of CIN in patients undergoing PCI such as low haematocrit, diabetes mellitus, CHF, BNP, were found to be correlated with CIN in our TAVR cohort.

Conclusions:

CIN is a frequent complication of TAVR. In accordance to current literature, low pre- procedure GFR and higher contrast volume are associated with increased risk of developing of this feared complication.