Impact of cystatin C-derived glomerular filtration rate in patients undergoing transcatheter aortic valve implantation

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Mana Ogawa¹  Atsushi Shibata¹  Tomohiro Yamaguchi¹  Daiju Fukuda¹  Yusuke Kure¹  Yasuhiro Izumiya¹  Asahiro Ito¹  Tsukasa Okai¹  Toshihiko Shibata²  Yosuke Takahashi²  Hisako Yoshida³  Kazuki Mizutani⁴ 

[1]Department of Cardiovascular Medicine, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

[2]Department of Cardiovascular Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

[3]Department of Medical Statistics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan

[4]Division of Cardiology, Department of Medicine, Kindai University Faculty of Medicine, Osaka, Japan

关键词: TAVI;    aortic stenosis;    cystatin c;    CKD;    creatinine;   

DOI  :  10.3389/fcvm.2023.1035736

 received in 2022-09-03, accepted in 2023-03-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundChronic kidney disease (CKD) impacts prognosis in patients undergoing transcatheter aortic valve implantation (TAVI). While estimated glomerular filtration rate (eGFR) calculated from serum creatinine [eGFR (creatinine)] is affected by body muscle mass which reflects frailty, eGFR calculated from serum cystatin C [eGFR (cystatin C)] is independent of body composition, resulting in better renal function assessment.MethodsThis study included 390 consecutive patients with symptomatic severe aortic stenosis (AS) who underwent TAVI, and measured cystatin C-based eGFR at discharge. Patients were divided into two groups, with or without CKD estimated with eGFR (cystatin C). The primary endpoint of this study was the 3-year all-cause mortality after TAVI.ResultsThe median patient age was 84 years, and 32.8% patients were men. Multivariate Cox regression analysis indicated that eGFR (cystatin C), diabetes mellitus, and liver disease were independently associated with 3-year all-cause mortality. In the receiver-operating characteristic (ROC) curve, the predictive value of eGFR (cystatin C) was significantly higher than that of eGFR (creatinine). Furthermore, Kaplan–Meier estimates revealed that 3-year all-cause mortality was higher in the CKD (cystatin C) group than that in the non-CKD (cystatin C) group with log-rank p = 0.009. In contrast, there was no significant difference between the CKD (creatinine) and non-CKD (creatinine) groups with log-rank p = 0.94.ConclusionseGFR (cystatin C) was associated with 3-year all-cause mortality in patients who underwent TAVI, and it was superior to eGFR (creatinine) as a prognostic biomarker.

【 授权许可】

Unknown   
© 2023 Kure, Okai, Izumiya, Yoshida, Mizutani, Yamaguchi, Ogawa, Shibata, Ito, Takahashi, Shibata and Fukuda.