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Independent Risk Factors Contributing to Acute Kidney Injury According to Updated Valve Academic Research Consortium-2 Criteria After Transcatheter Aortic Valve Implantation: A Meta-analysis and Meta-regression of 13 Studies

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机构: [1]Capital Med Univ, Beijing An Zhen Hosp, Dept Cardiac Surg, Beijing, Peoples R China; [2]Capital Med Univ, Beijing An Zhen Hosp, Ctr Cardiac Intens Care, Beijing 100029, Peoples R China
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关键词: acute kidney injury independent risk factor transcatheter aortic valve implantation Valve Academic Research Consortium-2

摘要:
Objectives: This study aimed to examine the risk factors for transcatheter aortic valve implantation (TAVI)-associated acute kidney injury (AKI) according to the AKI definition from the Valve Academic Research Consortium-2 (VARC-2). Setting: A meta-analysis. Participants: A total of 661 patients with post-TAVI AKI according to the VARC-2 definition and 2,012 controls were included in the meta analysis. Interventions: Patients undergoing TAVI were included in this meta-analysis. Measurements and Main Results: Multiple electronic databases were searched using predefined criteria. The diagnosis of AKI was based on the VARC-2 classification. The authors found that preoperative New York Heart Association class IV (odds ratio [OR], 7.77; 95% confidence interval [CI], 3.81-15.85), previous chronic renal disease (CKD) (OR, 2.81; 95% CI, 1.96-4.03), and requirement for transfusion (OR, 2.03; 95% CI, 1.59-2.59) were associated significantly with an increased risk for post-TAVI AKI. Furthermore, previous peripheral vascular disease (PVD), hypertension, atrial fibrillation, congestive heart failure, diabetes mellitus, and stroke were also risk factors for TAVI-associated AKI. Additionally, transfemoral access significantly correlated with a reduced risk for post-TAVI AKI (OR, 0.43; 95% CI, 0.33-0.57). The potential confounders, including Society of Thoracic Surgeons Score, the logistic European System for Cardiac Operative Risk Evaluation, aortic valve area, mean pressure gradient, left ventricular ejection fraction, age, body mass index, contrast volume, and valve type, had no impact on the association between the risk factors and post-TAVI AKI. Subgroup analysis of the eligible studies presenting multivariate logistic regression analysis on the independent risk factors for post-TAVI AM revealed that previous CKD, previous PVD, and transapical access were independent risk factors for TAVI-associated AM. Conclusions: The current meta-analysis suggested that previous CKD, previous PVD, and transapical access may be independent risk factors for TAVI-associated AM. (C) 2017 Published by Elsevier Inc.

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出版当年[2016]版:
大类 | 4 区 医学
小类 | 4 区 麻醉学 4 区 心脏和心血管系统 4 区 外周血管病 4 区 呼吸系统
最新[2023]版:
大类 | 4 区 医学
小类 | 4 区 麻醉学 4 区 心脏和心血管系统 4 区 外周血管病 4 区 呼吸系统
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出版当年[2015]版:
Q3 ANESTHESIOLOGY Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Q4 RESPIRATORY SYSTEM Q4 PERIPHERAL VASCULAR DISEASE
最新[2023]版:
Q2 ANESTHESIOLOGY Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Q2 PERIPHERAL VASCULAR DISEASE Q2 RESPIRATORY SYSTEM

影响因子: 最新[2023版] 最新五年平均 出版当年[2015版] 出版当年五年平均 出版前一年[2014版] 出版后一年[2016版]

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第一作者机构: [1]Capital Med Univ, Beijing An Zhen Hosp, Dept Cardiac Surg, Beijing, Peoples R China; [2]Capital Med Univ, Beijing An Zhen Hosp, Ctr Cardiac Intens Care, Beijing 100029, Peoples R China
通讯作者:
通讯机构: [2]Capital Med Univ, Beijing An Zhen Hosp, Ctr Cardiac Intens Care, Beijing 100029, Peoples R China
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