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Early acute kidney injury after transcatheter aortic valve implantation: predictive value of currently available risk scores

Publicated to:Hellenic Journal Of Cardiology. 70 19-27 - 2023-04-01 70(), DOI: 10.1016/j.hjc.2022.12.007

Authors: Loizzi, F; Palmitessa, C; Mancini, G; Iacovelli, F; Burattini, O; Cafaro, A; Spione, F; Salemme, L; Cioppa, A; Pucciarelli, A; Tesorio, T; Fimiani, L; Rimmaudo, F; Pignatelli, A; Bortone, AS; Contegiacomo, G

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Abstract

Background: Acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI) is a frequent complication associated with adverse outcomes and mortality. Various scores have been developed to predict this complication in the coronary setting. However, none have ever been tested in a large TAVI population. This study aimed to evaluate the power of four different scores in predicting AKI after TAVI. Methods: Overall, 1535 consecutive TAVI patients from the observational multicentric Magna Graecia TAVI registry were included in the analysis. Of the study population, 235 (15.31%) developed AKI early. The Mehran, William Beaumont Hospital, CR4EATME3AD3, and ACEF scores were calculated retrospectively. Results: The patients who developed TAVI-related AKI had significantly higher absolute values of all risk scores than those who did not. The receiver-operating characteristic analysis also showed a significant correlation between these four scores and AKI, but without a significant difference among all of them (p value = 0.176). Nevertheless, based on their area under the curve values (<0.604 for all), none had adequate diagnostic accuracy in predicting TAVI-related AKI. Importantly, multivariate analysis identified myocardial revascularization close to the TAVI procedure and implantation of self-expanding prostheses, as well as atrial fibrillation, low-osmolar contrast media administration, corrected contrast medium volume, and any transfusion (p value < 0.05 for all) as independent risk factors for AKI. Conclusions: Although high values of current AKI risk scores are significantly associated with the development of this complication, these are not sufficiently accurate. Further studies are needed so that a TAVI-dedicated AKI risk score may be created. (c) 2022 Hellenic Society of Cardiology. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Keywords

Acute kidney injuryAortic stenosisAortic stenosis,transcatheter aortic valve implantation&nbsp,(tavi),acute kidney injury,contrast-induced nephropathy,risk scorContrast-induced nephropathyContrast-induced nephropathy,percutaneous coronary intervention,end-point definitions,filtration-rate,impact,replacement,creatininCreatinineEnd-point definitionsFiltration-rateImpactPercutaneous coronary interventionReplacementRisk scoreTranscatheter aortic valve implantation (tavi)

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal Hellenic Journal Of Cardiology due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2023, it was in position 83/222, thus managing to position itself as a Q2 (Segundo Cuartil), in the category Cardiac & Cardiovascular Systems. Notably, the journal is positioned en el Cuartil Q2 para la agencia Scopus (SJR) en la categoría Cardiology and Cardiovascular Medicine.

From a relative perspective, and based on the normalized impact indicator calculated from World Citations provided by WoS (ESI, Clarivate), it yields a value for the citation normalization relative to the expected citation rate of: 1.29. This indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: ESI Nov 14, 2024)

This information is reinforced by other indicators of the same type, which, although dynamic over time and dependent on the set of average global citations at the time of their calculation, consistently position the work at some point among the top 50% most cited in its field:

  • Field Citation Ratio (FCR) from Dimensions: 4.17 (source consulted: Dimensions Jun 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-06-08, the following number of citations:

  • WoS: 6
  • Scopus: 6
  • OpenCitations: 6

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-06-08:

  • The use, from an academic perspective evidenced by the Altmetric agency indicator referring to aggregations made by the personal bibliographic manager Mendeley, gives us a total of: 30.
  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 25 (PlumX).

With a more dissemination-oriented intent and targeting more general audiences, we can observe other more global scores such as:

  • The Total Score from Altmetric: 4.05.
  • The number of mentions on the social network X (formerly Twitter): 5 (Altmetric).

It is essential to present evidence supporting full alignment with institutional principles and guidelines on Open Science and the Conservation and Dissemination of Intellectual Heritage. A clear example of this is:

  • The work has been submitted to a journal whose editorial policy allows open Open Access publication.
  • Additionally, the work has been submitted to a journal classified as Diamond in relation to this type of editorial policy.

Leadership analysis of institutional authors

This work has been carried out with international collaboration, specifically with researchers from: Italy; Switzerland.