Creatinine Score Can Predict Persistent Renal Dysfunction Following Trans-Catheter Aortic Valve Replacement

Area of Science:

• Cardiology
• Nephrology
• Interventional Cardiology

Background:

• Severe aortic stenosis (AS) frequently coexists with renal dysfunction, negatively impacting patient prognosis.
• Trans-catheter aortic valve replacement (TAVR) is a standard treatment for severe AS, but predicting post-procedural renal dysfunction remains a clinical challenge.

Purpose of the Study:

• To develop and evaluate a pre-procedural "Cre score" for assessing the risk of persistent renal dysfunction one year after TAVR.
• To determine if the Cre score can predict long-term survival in patients undergoing TAVR.

Main Methods:

• Retrospective analysis of 1,705 patients with severe AS from the OCEAN-TAVI registry who underwent TAVR.
• Calculation of the Cre score using baseline age and serum creatinine: 0.2 × (age) + 3.6 × (baseline serum creatinine).
• Assessment of persistent renal dysfunction (serum creatinine > 1.5 mg/dL) at one year post-TAVR and evaluation of 4-year survival rates.

Main Results:

• 14% of patients (246/1705) experienced persistent renal dysfunction one year after TAVR.
• The Cre score effectively predicted persistent renal dysfunction (IRR 1.48, P < 0.001) with a cutoff of 21.4.
• Higher Cre scores were associated with significantly lower 4-year survival rates (HR 1.75, P < 0.001).

Conclusions:

• The pre-procedural Cre score is a valuable tool for identifying patients at high risk of persistent renal dysfunction after TAVR.
• The Cre score also serves as a predictor of long-term survival following TAVR.
• Further research is warranted to explore the clinical implications of using the Cre score to guide therapeutic strategies.