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. 2023 May 24;10(6):228.
doi: 10.3390/jcdd10060228.

The Importance of Mehran Score to Predict Acute Kidney Injury in Patients with TAVI: A Large Multicenter Cohort Study

Salvatore Arrotti  1 , Fabio Alfredo Sgura  1 , Daniel Enrique Monopoli  1 , Valerio Siena  1 , Giulio Leo  1 , Vernizia Morgante  1 , Paolo Cataldo  1 , Paolo Magnavacchi  2 , Davide Gabbieri  3 , Vincenzo Guiducci  4 , Giorgio Benatti  5 , Luigi Vignali  5 , Giuseppe Boriani  1 , Rosario Rossi  1
Affiliations

The Importance of Mehran Score to Predict Acute Kidney Injury in Patients with TAVI: A Large Multicenter Cohort Study

Salvatore Arrotti et al. J Cardiovasc Dev Dis. .

Abstract

Background: Transcatheter aortic valve implantation (TAVI) has developed as an alternative to surgery for symptomatic high-risk patients with aortic stenosis (AS). An important complication of TAVI is acute kidney injury. The purpose of the study was to investigate if the Mehran Score (MS) could be used to predict acute kidney injury (AKI) in TAVI patients.

Methods: This is a multicenter, retrospective, observational study including 1180 patients with severe AS. The MS comprised eight clinical and procedural variables: hypotension, congestive heart failure class, glomerular filtration rate, diabetes, age >75 years, anemia, need for intra-aortic balloon pump, and contrast agent volume use. We assessed the sensitivity and specificity of the MS in predicting AKI following TAVI, as well as the predictive value of MS with each AKI-related characteristic.

Results: Patients were categorized into four risk groups based on MS: low (≤5), moderate (6-10), high (11-15), and very high (≥16). Post-procedural AKI was observed in 139 patients (11.8%). MS classes had a higher risk of AKI in the multivariate analysis (HR 1.38, 95% CI, 1.43-1.63, p < 0.01). The best cutoff for MS to predict the onset of AKI was 13.0 (AUC, 0.62; 95% CI, 0.57-0.67), whereas the best cutoff for eGFR was 42.0 mL/min/1.73 m2 (AUC, 0.61; 95% CI, 0.56-0.67).

Conclusions: MS was shown to be a predictor of AKI development in TAVI patients.

Keywords: Mehran Score; acute kidney injury; transcatheter aortic valve implantation.

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Conflict of interest statement

GB (Giuseppe Boriani) received small speaker’s fees from Boston, Boehringer, Bayer, Daiichi outside of the submitted work. The other authors declare no conflict of interest.

Figures

Figure 1
Figure 1
ROC curve for the prediction of AKI using Mehran Score (blue line). AUC for the prediction of AKI was 0.62; 95% CI: 0.57–0.67; sensitivity 70%; specificity 48%. The red line is the reference line.
Figure 2
Figure 2
ROC curves for the prediction of AKI using eGFR (blue line). AUC for the prediction of AKI was 0.61;95% C.I: 0.56–0.67; sensitivity 39%; specificity 76%. The red line is the reference line.
See this image and copyright information in PMC

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