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. 2022 Oct 10;15(19):1936-1945.
doi: 10.1016/j.jcin.2022.07.018. Epub 2022 Aug 22.

Acute Kidney Injury Following Tricuspid Transcatheter Edge-to-Edge Repair

Tetsu Tanaka  1 , Refik Kavsur  1 , Atsushi Sugiura  1 , Jean Marc Haurand  2 , Natalia Galka  1 , Can Öztürk  1 , Johanna Vogelhuber  1 , Marc Ulrich Becher  1 , Marcel Weber  1 , Ralf Westenfeld  2 , Sebastian Zimmer  1 , Malte Kelm  2 , Georg Nickenig  1 , Patrick Horn  2 , Christian Zachoval  3
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Free article

Acute Kidney Injury Following Tricuspid Transcatheter Edge-to-Edge Repair

Tetsu Tanaka et al. JACC Cardiovasc Interv. .
Free article

Abstract

Background: Little is known about the incidence and clinical relevance of postprocedural acute kidney injury (AKI) in patients undergoing transcatheter edge-to-edge repair (TEER) for tricuspid regurgitation (TR).

Objectives: The aim of this study was to investigate the prognostic impact of postprocedural AKI following TEER for TR.

Methods: Two hundred sixty-eight patients who underwent TEER for TR at 2 centers were retrospectively analyzed. Postprocedural AKI was defined as an increase in serum creatinine of ≥0.3 mg/dL within 48 hours or ≥50% within 7 days after the procedure compared with baseline. The association between AKI and the composite outcome, consisting of all-cause mortality and rehospitalization for heart failure within 1 year after the procedure, was determined.

Results: The mean age of the patients was 79.0 ± 6.8 years, and 43.3% were men. Postprocedural AKI occurred in 42 patients (15.7%). Age, male sex, an estimated glomerular filtration rate of <60 mL/min/1.73 m2, and absence of procedural success were associated with the occurrence of AKI. Patients with AKI had a higher incidence of in-hospital mortality than those without AKI (9.5% vs 0.9%; P = 0.006). Moreover, AKI was associated with the incidence of the composite outcome within 1 year after TEER for TR (adjusted HR: 2.39; 95% CI: 1.45-3.94; P = 0.001).

Conclusions: Postprocedural AKI occurred in 15.7% of patients undergoing TEER for TR, despite the absence of iodinated contrast agents, which was associated with worse clinical outcomes. These findings highlight the clinical impact of AKI following TEER for TR and should help in identifying patients at high risk for AKI.

Keywords: acute kidney injury; tricuspid regurgitation; tricuspid transcatheter edge-to-edge repair.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Tanaka was financially supported in part by fellowships from the Japanese College of Cardiology and the Uehara Memorial Foundation. Dr Sugiura has received honoraria for lectures from Edwards Lifesciences. Dr Weber has received lecture or proctoring fees from Abbott and Edwards Lifesciences. Drs Nickenig and Zimmer have received research funding from Deutsche Forschungsgemeinschaft, the German Federal Ministry of Education and Research, the European Union, Abbott, Edwards Lifesciences, and Medtronic; and have received honoraria for lectures or advisory boards from Abbott, Edwards Lifesciences, and Medtronic. Dr Horn has received travel support from Abbott and Edwards Lifesciences; and has received an unrestricted research grant from Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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