Table 1.
Other baseline characteristics and procedural features of the study population according to AKI incidence and CM osmolality (n = 697).
| AKI |
Osmolality |
||||||
|---|---|---|---|---|---|---|---|
| Yes | No | IOCM | LOCM | ||||
| Variable | All | (n = 88) | (n = 609) | p | (n = 370) | (n = 327) | p |
| Anamnesis | |||||||
| Severe liver disease | 23 (3.30%) | 1 (1.14%) | 22 (3.61%) | 0.370 | 13 (4.05%) | 8 (2.45%) | 0.330 |
| Critical preoperative state | 38 (5.45%) | 6 (6.82%) | 32 (5.26%) | 0.724 | 16 (4.32%) | 22 (6.73%) | 0.220 |
| Prior myocardial revascularization | 172 (24.68%) | 20 (22.73%) | 152 (24.96%) | 0.748 | 105 (28.38%) | 67 (20.49%) | 0.020 |
| PCI | 96 (13.77%) | 14 (15.91%) | 82 (13.47%) | 0.648 | 57 (15.41%) | 38 (11.93%) | 0.223 |
| CABG | 44 (6.31%) | 2 (2.27%) | 42 (6.90%) | 0.152 | 26 (7.03%) | 18 (5.51%) | 0.504 |
| PCI + CABG | 32 (4.59%) | 4 (4.55%) | 28 (4.60%) | 0.802 | 22 (5.95%) | 10 (3.06%) | 0.102 |
| Myocardial revascularization for TAVI | 87 (12.48%) | 15 (17.05%) | 72 (11.82%) | 0.225 | 45 (12.16%) | 42 (12.84%) | 0.875 |
| PCI | 84 (12.05%) | 15 (17.05%) | 69 (11.33%) | 0.172 | 43 (11.62%) | 41 (12.54%) | 0.799 |
| CABG | 2 (0.29%) | 0 (0.00%) | 2 (0.33%) | 0.598 | 2 (0.54%) | 0 (0.00%) | 0.534 |
| PCI + CABG | 1 (0.14%) | 0 (0.00%) | 1 (0.16%) | 0.260 | 0 (0.00%) | 1 (0.31%) | 0.951 |
| Prior PM/ICD/CRT implantation | 81 (11.62%) | 17 (19.32%) | 64 (10.51%) | 0.026 | 41 (11.08%) | 40 (12.23%) | 0.723 |
| Baseline renal function assessment | |||||||
| SCr (mg/dL) | 1.08±0.42 | 1.11±0.54 | 1.07±0.40 | 0.621 | 1.09±0.50 | 1.07±0.39 | 0.907 |
| CrCl (mL/min) | 56.53±22.81 | 56.50±24.81 | 56.66±22.54 | 0.972 | 56.08±23.29 | 57.28±22.29 | 0.394 |
| eGFR (mL/min/1.73 m2) | 69.03±25.63 | 70.06±30.32 | 68.88±24.90 | 0.878 | 69.14±26.17 | 68.91±25.03 | 0.939 |
| Electrocardiography | |||||||
| Sinus rhythm | 533 (76.47%) | 67 (76.14%) | 466 (76.52%) | 0.956 | 287 (77.57%) | 246 (75.23%) | 0.524 |
| Atrial fibrillation / flutter | 116 (16.64%) | 11 (12.50%) | 107 (17.57%) | 0.335 | 63 (17.03%) | 53 (16.21%) | 0.851 |
| PM-induced rhythm | 48 (6.89%) | 10 (11.36%) | 38 (6.24%) | 0.121 | 20 (5.41%) | 28 (8.56%) | 0.135 |
| Echocardiography | |||||||
| LVEF (%) | 52.86±11.13 | 52.09±11.91 | 52.97±11.02 | 0.502 | 53.24±12.16 | 52.44±9.83 | 0.932 |
| Maximum aortic gradient (mmHg) | 76.20±20.76 | 76.41±22.05 | 76.17±20.60 | 0.959 | 72.41±19.91 | 80.23±20.93 | <0.001 |
| Mean aortic gradient (mmHg) | 46.92±14.39 | 45.76±14.66 | 47.09±14.35 | 0.547 | 45.43±13.88 | 48.58±14.78 | 0.004 |
| Moderate-to-severe mitral regurgitation | 162 (23.24%) | 23 (26.14%) | 139 (22.82%) | 0.581 | 105 (28.38%) | 57 (17.43%) | <0.001 |
| Pulmonary arterial systolic pressure (mmHg) | 40.01±12.76 | 40.53±12.38 | 39.93±12.83 | 0.678 | 39.42±12.35 | 40.59±13.15 | 0.419 |
| CT-guided procedure | 652 (93.54%) | 81 (92.05%) | 571 (93.76%) | 0.704 | 353 (95.41%) | 299 (91.44%) | 0.049 |
| Procedural details | |||||||
| Transfemoral access route | 620 (88.95%) | 71 (81.82%) | 548 (89.98%) | 0.036 | 323 (87.30%) | 297 (90.82%) | 0.173 |
| Other access routes | 77 (11.05%) | 16 (18.18%) | 61 (10.02%) | 0.036 | 47 (12.70%) | 30 (9.17%) | 0.173 |
| transsubclavian | 21 (3.01%) | 1 (1.14%) | 20 (3.28%) | 0.442 | 4 (1.08%) | 17 (5.20%) | 0.003 |
| transapical | 50 (7.17%) | 11 (12.50%) | 39 (6.40%) | 0.064 | 40 (10.81%) | 10 (3.06%) | <0.001 |
| direct aortic | 6 (0.86%) | 4 (4.45%) | 2 (0.33%) | <0.001 | 3 (0.81%) | 3 (0.92%) | 0.796 |
| Orotracheal intubation | 203 (29.12%) | 26 (29.55%) | 177 (29.06%) | 0.974 | 145 (39.19%) | 58 (17.74%) | <0.001 |
| Valve-in-valve | 19 (2.73%) | 0 (0.00%) | 19 (3.12%) | 0.184 | 10 (2.70%) | 9 (2.75%) | 0.847 |
| Predilation | 425 (60.98%) | 39 (44.32%) | 233 (38.26%) | 0.331 | 253 (68.38%) | 172 (52.59%) | <0.001 |
| Valve kind | |||||||
| balloon-expandable | 436 (62.55%) | 59 (67.05%) | 377 (61.90%) | 0.416 | 209 (56.49%) | 227 (69.42%) | <0.001 |
| self-expandable | 228 (32.71%) | 28 (32.82%) | 200 (32.84%) | 0.945 | 139 (37.57%) | 89 (27.22%) | 0.005 |
| others | 33 (4.73) | 1 (1.14%) | 32 (5.26%) | 0.152 | 22 (5.94%) | 11 (3.36%) | 0.155 |
| Valve size | |||||||
| ≤26 mm | 533 (76.47%) | 65 (73.86%) | 468 (76.85%) | 0.630 | 270 (72.97%) | 263 (80.43%) | 0.026 |
| >26 mm | 164 (23.53%) | 23 (26.14%) | 141 (23.15%) | 0.630 | 100 (27.03%) | 64 (19.57%) | 0.026 |
| Postdilation | 86 (12.34%) | 11 (12.50%) | 75 (12.32%) | 0.901 | 61 (16.49%) | 25 (7.64%) | <0.001 |
| CM volume (mL) | 166.10±60.61 | 171.60±72.44 | 165.30±70.36 | 0.475 | 185.34±71.83 | 144.32±62.52 | <0.001 |
| CM volume x SCr/BW | 2.50±1.39 | 2.70±1.69 | 2.47±1.34 | 0.602 | 2.81±1.42 | 2.15±1.26 | <0.001 |
| CM volume x SCr/BW >2.7 | 235 (33.72%) | 33 (37.50%) | 202 (33.17%) | 0.495 | 164 (44.32%) | 71 (21.71%) | <0.001 |
| CM volume/CrCl | 3.40±2.03 | 3.77±2.54 | 3.34±1.94 | 0.292 | 3.83±2.12 | 2.91±1.79 | <0.001 |
| CM volume/CrCl >3.7 | 231 (33.14%) | 35 (39.77%) | 196 (32.18%) | 0.196 | 155 (41.89%) | 76 (23.24%) | <0.001 |
| CM volume/eGFR | 2.74±1.58 | 3.05±1.96 | 2.70±1.51 | 0.359 | 3.05±1.58 | 2.40±1.50 | <0.001 |
| CM volume/eGFR >3.9 | 124 (17.79%) | 23 (26.13%) | 101 (16.58%) | 0.041 | 87 (23.51%) | 37 (11.31%) | <0.001 |
| Mehran score ≥11 | 482 (69.15%) | 62 (70.45%) | 420 (68.97%) | 0.873 | 280 (75.68%) | 202 (61.77%) | <0.001 |
| IOCM | 370 (53.08%) | 36 (40.91%) | 334 (54.84%) | 0.020 | |||
| LOCM | 327 (46.92%) | 52 (59.09%) | 275 (45.16%) | 0.020 | |||
| iopromide | 130 (18.65%) | 11 (12.50%) | 119 (19.54%) | 0.005 | |||
| iobitridol | 92 (13.20%) | 16 (18.18%) | 76 (12.48%) | 0.770 | |||
| iohexol | 80 (11.48%) | 18 (20.45%) | 62 (10.18%) | 0.093 | |||
| iomeprol | 25 (3.59%) | 7 (7.95%) | 18 (2.96%) | 0.151 | |||
| Post-TAVI and discharge renal function assessment | |||||||
| Post-TAVI peak SCr (mg/dL) | 1.12±0.51 | 1.72±0.87 | 1.03±0.35 | <0.001 | 1.08±0.51 | 1.16±0.50 | 0.001 |
| Post-TAVI peak – basal ΔSCr (mg/dL) | 0.04±0.35 | 0.61±0.63 | −0.04±0.18 | <0.001 | −0.01±0.33 | 0.09±0.37 | <0.001 |
| Post-TAVI nadir CrCl (mL/min) | 55.80±24.01 | 38.09±19.13 | 58.37±23.56 | <0.001 | 57.80±26.28 | 53.51±20.92 | 0.115 |
| Basal – post-TAVI nadir ΔCrCl (mL/min) | 0.84±12.30 | 18.40±14.67 | −1.70±9.55 | <0.001 | −1.72±13.17 | 3.76±10.52 | <0.001 |
| Post-TAVI nadir eGFR (mL/min/1.73 m2) | 67.94±27.31 | 44.64±22.73 | 71.31±26.26 | <0.001 | 71.37±29.63 | 64.05±23.88 | 0.002 |
| Basal – post-TAVI nadir ΔeGFR (mL/min/1.73 m2) | 1.09±16.83 | 25.41±19.62 | −2.42±13.08 | <0.001 | −2.24±18.17 | 4.86±14.29 | <0.001 |
| Discharge SCr (mg/dL) | 1.06±0.47 | 1.37±0.83 | 1.01±0.38 | <0.001 | 1.03±0.49 | 1.07±0.46 | 0.008 |
| Discharge – basal ΔSCr (mg/dL) | −0.35±0.35 | 0.26±0.68 | −0.07±0.24 | <0.001 | −0.06±0.35 | 0.00±0.34 | <0.001 |
| Discharge – post-TAVI peak ΔSCr (mg/dL) | −0.07±0.31 | −0.35±0.64 | −0.03±0.19 | <0.001 | −0.06±0.30 | −0.09±0.32 | 0.045 |
| Discharge CrCl (mL/min) | 59.32±25.67 | 49.42±25.43 | 60.75±25.41 | <0.001 | 61.36±28.27 | 57.02±22.19 | 0.240 |
| Basal – discharge ΔCrCl (mL/min) | −2.92±12.55 | 7.08±16.92 | −4.38±11.07 | <0.001 | −5.27±13.93 | 0.27±10.16 | <0.001 |
| Discharge – post-TAVI nadir ΔCrCl (mL/min) | 3.76±10.68 | 11.33±14.48 | 2.67±9.55 | <0.001 | 3.55±12.01 | 4.00±8.98 | 0.066 |
| Discharge eGFR (mL/min/1.73 m2) | 73.24±29.42 | 60.67±33.41 | 75.06±28.37 | <0.001 | 76.61±32.58 | 69.42±24.87 | 0.007 |
| Basal – discharge ΔeGFR (mL/min/1.73 m2) | −4.21±17.42 | 9.38±23.99 | −6.17±15.37 | <0.001 | −7.47±19.65 | −0.52±13.73 | <0.001 |
| Discharge – post-TAVI nadir ΔeGFR (mL/min/1.73 m2) | 5.30±15.09 | 16.03±20.42 | 3.75±13.49 | <0.001 | 5.24±16.83 | 5.37±12.86 | 0.171 |
AKI = acute kidney injury; CM = contrast medium; IOCM = iso-osmolar contrast medium; LOCM = low-osmolar contrast media; PCI = percutaneous coronary intervention; CABG = coronary artery by-pass grafting; TAVI = transcatheter aortic valve implantation; PM = pacemaker; ICD = implantable cardioverter-defibrillator; CRT = cardiac resynchronization therapy; SCr = serum creatinine; CrCl = creatinine clearance; eGFR = estimated glomerular filtration ratio; LVEF = left ventricular ejection fraction; CT = computed tomography; BW = body weight.