Charlson Comorbidity Index predicts contrast-induced nephropathy following transcatheter aortic valve replacement.

Abstract

Introduction: Transcatheter aortic valve replacement (TAVR) is increasingly used for the management of patients with severe aortic stenosis at high risk for surgical valve replacement. In this setting, we analysed the potential value of the Charlson Comorbidity Index (CCI) in contrast-induced nephropathy (CIN) prediction in subjects undergoing TAVR.

Material and methods: We analysed consecutive subjects who had undergone TAVR at our institution between June 2013 and March 2023, and defined their co-morbid conditions as measured with the CCI. Thereafter, we analysed the association of this index with CIN development following TAVR. In this context, the CCI score was calculated separately for each subject. The subjects were then categorized into two groups based on their CIN status: CIN- group and CIN+ group.

Results: In a population of 118 subjects (mean age: 79.3 ±6.8 years), the mean CCI score was found to be 4.83 ±1.32. The CIN+ group had a significantly higher mean CCI value in comparison to the CIN- group (5.80 ±1.15 vs. 4.56 ±1.25, p < 0.001). After multivariable adjustment, CCI was found to have an independent association with CIN evolution (OR = 1.845, 95% CI: 1.053-3.233, p = 0.032). The area under the ROC curve was 0.766 (95% CI: 0.663-0.869, p < 0.001), whereas the sensitivity and specificity values were 78.0% and 52.0%, respectively, based on an optimum cut-off value of 4.5.

Conclusions: The CCI was independently associated with CIN evolution and may help predict CIN alongside other risk models after TAVR.