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

Abstract

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). The aim of this study was to investigate the prognostic impact of postprocedural AKI following TEER forTR. 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≥0.3mg/dL within 48 hours or≥50% within 7days 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. The mean age of the patients was 79.0 ± 6.8 years, and 43.3% were men. Postprocedural AKI occurred in 42patients (15.7%). Age, male sex, an estimated glomerular filtration rate of<60mL/min/1.73m2, 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). Postprocedural AKI occurred in 15.7% of patients undergoing TEER for TR, despite the absence ofiodinated contrast agents, which was associated with worse clinical outcomes. These findings highlight the clinicalimpactof AKI following TEER for TR and should help in identifying patients at high risk for AKI.