CHA2DS2-VASc SCORE FOR PREDICTING THE RISK OF CONTRAST-INDUCED NEPHROPATHY AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT Transkateter Aort Kapak Replasmanı Sonrası Kontrasta Bağlı Nefropati Riskini Öngörmek için CHA2DS2-VASc Skoru

Year 2024, Volume: 14 Issue: 4, 262 - 268, 15.12.2024

Can Özkan

Abstract

ABSTRACT
Objective: Contrast induced nephropathy (CIN) is a condition that may develop due to percutaneous cardiac
interventional procedures and may adversely affect the prognosis of patients. The CHA2DS2-VASc score
has been shown to be an independent predictor of acute kidney injury (AKI) and indicates an unfavorable
prognosis in patients with acute coronary syndrome (ACS). Awareness of the risk of AKI before transaortic
valve replacement (TAVR) may help to reduce the rate of AKI. Therefore, i aimed to evaluate the utility of
CHA2DS2 VASC score in patients undergoing TAVR.
Material and Methods: Retrospective date of 60 patients who underwent TAVR was collected between
February 2022 and October 2023. The decision for the TAVR procedure was made according to international
guidelines and the consensus of the local cardiac team for patients with advanced aortic stenosis and high
surgical risk or contraindication to surgical valve replacement.
Results: There were no significant differences between the two groups in terms of age, gender, prevalence
of diabetes mellitus, dyslipidemia, previous medications, baseline systolic and diastolic blood pressure,
and body mass index. High CHA2DS2-VASc score (OR: 2.138, 95% confidence interval (CI): 1.356-4.125; p =
0.027) levels were independently associated with the presence of CIN. Furthermore, contrast volume (OR:
1.192, 95%CI: 1.022-1.390; p = 0.031) independently predicted the presence of CIN.
Conclusion: This study demonstrated that the CHA2DS2-VASc score can be used as a predictor of CIN in
patients undergoing TAVR. Early prediction of CIN risk is critical to provide intensive preventive measures to
patients at high risk. The CHA2DS2-VASc score is a simple and familiar scoring tool that can be applied in patients
undergoing TAVR and can predict the development of CIN and can be easily applied in daily practice.

Keywords

CHA2DS2-VASc SCORE FOR PREDICTING THE RISK OF CONTRAST-INDUCED NEPHROPATHY AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT, Transkateter Aort Kapak Replasmanı Sonrası Kontrasta Bağlı Nefropati Riskini Öngörmek için CHA2DS2-VASc Skoru, CHA2DS2-VASc SCORE FOR PREDICTING THE RISK OF

References

• 1. Makris K, Spanou L. Acute kidney injury: definition, pathophysiology and clinical phenotypes. The clinical biochemist reviews. 2016;37(2):85-98.
• 2. Golshahi J, Nasri H, Gharipour M. Contrast-induced nephropathy; A literature review. Journal of nephropathology. 2014;3(2):51-6.
• 3. Mehran R, Nikolsky E. Contrast-induced nephropathy: definition, epidemiology, and patients at risk. Kidney international. 2006;69:S11-5.
• 4. Gurm HS, Dixon SR, Smith DE, Share D, LaLonde T, Greenbaum A, et al. Renal function-based contrast dosing to define safe limits of radiographic contrast media in patients undergoing percutaneous coronary interventions. J Am Coll Cardiol. 2011;58(9):907-14.
• 5. Tsai TT, Patel UD, Chang TI, Kennedy KF, Masoudi FA, Matheny ME, et al. Contemporary incidence, predictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry. JACC Cardiovasc Interv. 2014;7(1):1-9.
• 6. Fath AR, Aglan A, Khurana A, Abuasbeh J, Eldaly AS, Mantha Y, et al. Transcatheter Aortic Valve Replacement: Variations in Use, Charges,and Geography in the United States. Am J Cardiol. 2023;205:363-8.
• 7. Elhmidi Y, Bleiziffer S, Piazza N, Hutter A, Opitz A, Hettich I, et al. Incidence and predictors of acute kidney injury in patients undergoing transcatheter aortic valve implantation. Am Heart J. 2011;161(4):735-9.
• 8. Loizzi F, Burattini O, Cafaro A, Spione F, Salemme L, Cioppa A, et al. Early acute kidney injury after transcatheter aortic valve implantation: predictive value of currently available risk scores. Hellenic J Cardiol. 2023;70:19-27.
• 9. Codner P, Levi A, Gargiulo G, Praz F, Hayashida K, Watanabe Y, et al. Impact of renal dysfunction on results of transcatheter aortic valve replacement outcomes in a large multicenter cohort. Am J Cardiol. 2016;118(12):1888-96.
• 10. Mach M, Hasan W, Andreas M, Winkler B, Weiss G, Adlbrecht C, et al. Evaluating the association between contrast medium dosage and acute kidney injury in transcatheter aortic valve replacement using different predictive models. J Clin Med. 2020;9(11):3476.