• Int. J. Cardiol. · Oct 2016

    Impact of post-procedural hyperglycemia on acute kidney injury after transcatheter aortic valve implantation.

    • Francesco Giannini, Azeem Latib, Richard J Jabbour, Neil Ruparelia, Andrea Aurelio, Marco B Ancona, Filippo Figini, Antonio Mangieri, Damiano Regazzoli, Akihito Tanaka, Claudio Montalto, Lorenzo Azzalini, Fabrizio Monaco, Eustachio Agricola, Alaide Chieffo, Matteo Montorfano, Ottavio Alfieri, and Antonio Colombo.
    • Interventional Cardiology, San Raffaele Hospital, Milan, Italy; EMO-GVM Centro Cuore Columbus, Milan, Italy. Electronic address: giannini_fra@yahoo.it.
    • Int. J. Cardiol. 2016 Oct 15; 221: 892-7.

    BackgroundPost-operative hyperglycemia, in individuals with and without diabetes, has been identified as a predictor of acute kidney injury (AKI) in patients following cardiac surgery. Whether or not this is also true for patients undergoing transcatheter aortic valve implantation (TAVI) is unknown.ObjectivesTo evaluate whether post-procedural glucose levels are associated with AKI after TAVI.Methods And ResultsA total of 422 consecutive patients undergoing transfemoral TAVI were included in the analysis. For each patient, plasma glucose levels were assessed at hospital admission, 4h after the procedure and daily during hospitalization. Post-procedural hyperglycemia was defined as 2 consecutive blood glucose readings ≥150mg/dL in the 72-hour period following TAVI. AKI was defined according to the VARC consensus report regarding standardized endpoint definitions. Overall, 137 (32.5%) patients developed post-procedural hyperglycemia and 138 (33%) patients developed AKI. Hyperglycemia was associated with a 2-fold higher incidence of AKI than in patients without hyperglycemia (48% vs. 25%, p<0.001). In-hospital mortality was higher in patients with hyperglycemia than in those without hyperglycemia (9.6% vs. 1.8%, p<0.001). In-hospital mortality rate was also higher in patients who developed AKI (12.7% vs. 2.7%, p<0.001). Patients with acute hyperglycemia that developed AKI had the highest in-hospital and long-term mortality rate (15% and 38%). Post-procedural hyperglycemia was an independent predictor of AKI.ConclusionsPost-procedural hyperglycemia is associated with a higher incidence of AKI and mortality after TAVI. Randomized controlled trials are needed to determine whether meticulous post-procedural glycemic control following TAVI impacts upon clinical outcomes.Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

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