Author + information
- Luis Nombela-Franco1,
- Josep Rodes-Cabau2,
- Ignacio Cruz-Gonzalez3,
- Xavi Freixa4,
- Luis Asmarats5,
- Hipolito Gutierrez6,
- Tania Rodriguez-Gabella2,
- Jose Carlos Moreno-Samos3,
- Gabriela Tirado-Conte1,
- L.R. Goncalves-Ramirez6,
- Juan Carlos Rama Merchan3,
- Ignacio Amat-Santos6,
- Gilles O'Hara2,
- Pilar Jimenez-Quevedo1,
- Armando Bethencourt5,
- Victoria Martin-Yuste4 and
- Carlos Macaya1
- 1Hospital Clínico San Carlos, Madrid, Spain
- 2Quebec Heart and Lung Institute, Quebec City, Quebec, Canada, Quebec, QC, Canada
- 3Cardiology Department. University Hospital of Salamanca, Biomedical Research Institute of Salamanca (IBSAL). CIBER-CV, Salamanca, Spain
- 4Hospital Clinic of Barcelona, Barcelona, Spain
- 5Hospital Universitari Son Espases, Palma, Spain
- 6Institute of Heart Sciences (ICICOR), Hospital Clínico Universitario of Valladolid, Valladolid, Spain
No data exist on the occurrence of acute kidney injury (AKI) after left atrial appendage closure (LAAC). The aims of this registry were to determine the incidence, predictors and prognostic value of periprocedural AKI after LAAC.
A total of 355 patients undergoing LAAC were included in the study. Acute kidney injury was defined as an absolute or a relative increase in serum creatinine of >0.3mg/dl or ≥50%, respectively, after the procedure or the need for haemodialysis during index hospitalization.
The incidence of AKI was 9%, and patients with worse baseline renal function were at higher risk of developing AKI (OR: 1.32, 95% CI 1.09-1.61, p=0.004 for each 10ml/min decrease in the glomerular filtration rate). In-hospital bleeding events occurred more frequently in the AKI group (5.3% versus 15.6%, p=0.037). After a median follow-up of 18 months, patients in the AKI group had a higher mortality (HR 2.59, 95% CI 1.36-4.92, p=0.004), more embolic events (HR 6.14, 95% CI 2.23-16.92, p=0.001) and major bleeding events (HR 2.36, 95% CI 0.89-6.24, p=0.083). The occurrence of AKI was an independent predictor of mid-term mortality (HR 2.00, 95% CI 1.02-3.91, p=0.044).
The occurrence of AKI is relatively frequent in patients undergoing LAAC, and patients with lower renal glomerular filtration rate were at high risk of developing this complication. Acute kidney injury was correlated with worse mid-term outcomes, highlighting the importance of further preventive strategies in this population.