Predictive value of ACEF score for acute kidney injury after surgical aortic valve replacement

Gökhan Demirci; Ali Rıza Demir; Serkan Kahraman; Sencer Çamcı; Emre Yılmaz

doi:10.18621/eurj.1334048

Research Article

Year 2024, Volume: 10 Issue: 3, 254 - 261, 04.05.2024

Gökhan Demirci Ali Rıza Demir Serkan Kahraman Sencer Çamcı Emre Yılmaz

https://doi.org/10.18621/eurj.1334048

Abstract

References

1. Kang DH, Park SJ, Lee SA, et al. Early surgery or conservative care for asymptomatic aortic stenosis. N Engl J Med. 2020;382(2):111-119. doi: 10.1056/NEJMoa1912846.
2. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Spontaneous course of aortic valve disease. Eur Heart J. 1987;8(5):471-483. doi: 10.1093/oxfordjournals.eurheartj.a062307.
3. VARC-3 WRITING COMMITTEE; Généreux P, Piazza N, Alu MC, et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. J Am Coll Cardiol. 2021;77(21):2717-2746. doi: 10.1016/j.jacc.2021.02.038.
4. Yildiz I, Yildiz PO, Rencuzogullari I, et al. Association of serum osmolarity with contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction. Angiology. 2019;70(7):627-632. doi: 10.1177/0003319719826466.
5. Karabağ Y, Çağdaş M, Rencuzogullari I, et al. The C-reactive protein to albumin ratio predicts acute kidney injury in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Heart Lung Circ. 2019;28(11):1638-1645. doi: 10.1016/j.hlc.2018.08.009.
6. Kumar N, Garg N. Acute kidney injury after aortic valve replacement in a nationally representative cohort in the USA. Nephrol Dial Transplant. 2019;34(2):295-300. doi: 10.1093/ndt/gfy097.
7. Ranucci M, Castelvecchio S, Menicanti L, Frigiola A, Pelissero G. Risk of assessing mortality risk in elective cardiac operations: age, creatinine, ejection fraction, and the law of parsimony. Circulation. 2009;119(24):3053-3061. doi: 10.1161/CIRCULATIONAHA.108.842393.
8. Chang CH, Lee CC, Chen SW, et al. Predicting acute kidney injury following mitral valve repair. Int J Med Sci. 2016;13(1):19-24. doi: 10.7150/ijms.13253.
9. Chen SW, Chang CH, Fan PC, et al. Comparison of contemporary preoperative risk models at predicting acute kidney injury after isolated coronary artery bypass grafting: a retrospective cohort study. BMJ Open. 2016;6(6):e010176. doi: 10.1136/bmjopen-2015-010176.
10. Andò G, Morabito G, de Gregorio C, Trio O, Saporito F, Oreto G. Age, glomerular filtration rate, ejection fraction, and the AGEF score predict contrast-induced nephropathy in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Catheter Cardiovasc Interv. 2013;82(6):878-885. doi: 10.1002/ccd.25023.
11. Uygur B, Celik O, Demir AR, et al. A simplified acute kidney injury predictor following transcatheter aortic valve implantation: ACEF score. Kardiol Pol. 2021;79(6):662-668. doi: 10.33963/KP.15933.
12. Rana M. Aortic valve stenosis: diagnostic approaches and recommendations of the 2021 ESC/EACTS guidelines for the management of valvular heart disease -A review of the literature. Cardiol Cardiovasc Med. 2022;6(3):315-324. doi: 10.26502/fccm.92920267.
13. Hirji SA, Funamoto M, Lee J, et al. Minimally invasive versus full sternotomy aortic valve replacement in low-risk patients: Which will stand against transcatheter aortic valve replacement? Surgery. 2018;164(2):282-287. doi: 10.1016/j.surg.2018.02.018.
14. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31-41. doi: 10.1159/000180580.
15. Wykrzykowska JJ, Garg S, Onuma Y, et al. Value of age, creatinine, and ejection fraction (ACEF score) in assessing risk in patients undergoing percutaneous coronary interventions in the 'All-Comers' LEADERS trial. Circ Cardiovasc Interv. 2011;4(1):47-56. doi: 10.1161/CIRCINTERVENTIONS.110.958389.
16. Parolari A, Pesce LL, Pacini D, et al; Monzino Research Group on Cardiac Surgery Outcomes. Risk factors for perioperative acute kidney injury after adult cardiac surgery: role of perioperative management. Ann Thorac Surg. 2012;93(2):584-591. doi: 10.1016/j.athoracsur.2011.09.073.
17. Brown JR, Kramer RS, Coca SG, Parikh CR. Duration of acute kidney injury impacts long-term survival after cardiac surgery. Ann Thorac Surg. 2010;90(4):1142-1148. doi: 10.1016/j.athoracsur.2010.04.039.
18. Englberger L, Suri RM, Li Z, et al. Clinical accuracy of RIFLE and Acute Kidney Injury Network (AKIN) criteria for acute kidney injury in patients undergoing cardiac surgery. Crit Care. 2011;15(1):R16. doi: 10.1186/cc9960.
19. Hobson CE, Yavas S, Segal MS, et al. Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery. Circulation. 2009;119(18):2444-2453. doi: 10.1161/CIRCULATIONAHA.108.800011.
20. Grayson AD, Khater M, Jackson M, Fox MA. Valvular heart operation is an independent risk factor for acute renal failure. Ann Thorac Surg. 2003;75(6):1829-1835. doi: 10.1016/s0003-4975(03)00166-8.
21. Najjar M, Salna M, George I. Acute kidney injury after aortic valve replacement: incidence, risk factors and outcomes. Expert Rev Cardiovasc Ther. 2015;13(3):301-316. doi: 10.1586/14779072.2015.1002467.
22. Araujo GN, Pivatto Junior F, Fuhr B, et al. Simplifying contrast-induced acute kidney injury prediction after primary percutaneous coronary intervention: the age, creatinine and ejection fraction score. Cardiovasc Interv Ther. 2018;33(3):224-231. doi: 10.1007/s12928-017-0472-y.
23. Laurent M, Fournet M, Feit B, et al. Simple bedside clinical evaluation versus established scores in the estimation of operative risk in valve replacement for severe aortic stenosis. Arch Cardiovasc Dis. 2013;106(12):651-660. doi: 10.1016/j.acvd.2013.09.001.
24. Thakar CV. Perioperative acute kidney injury. Adv Chronic Kidney Dis. 2013;20(1):67-75. doi: 10.1053/j.ackd.2012.10.003.
25. Hertzberg D, Sartipy U, Lund LH, Rydén L, Pickering JW, Holzmann MJ. Heart failure and the risk of acute kidney injury in relation to ejection fraction in patients undergoing coronary artery bypass grafting. Int J Cardiol. 2019;274:66-70. doi: 10.1016/j.ijcard.2018.09.092.
26. Callejas R, Panadero A, Vives M, Duque P, Echarri G, Monedero P; Renal Dysfunction in Cardiac Surgery Spanish Group (GEDRCC2). Preoperative predictive model for acute kidney injury after elective cardiac surgery: a prospective multicenter cohort study. Minerva Anestesiol. 2019;85(1):34-44. doi: 10.23736/S0375-9393.18.12257-7.

Predictive value of ACEF score for acute kidney injury after surgical aortic valve replacement

Year 2024, Volume: 10 Issue: 3, 254 - 261, 04.05.2024

Gökhan Demirci Ali Rıza Demir Serkan Kahraman Sencer Çamcı Emre Yılmaz

https://doi.org/10.18621/eurj.1334048

Abstract

Objectives: Aortic stenosis is the most common form of degenerative heart valve disease. Acute kidney injury (AKI) after aortic valve replacement (AVR) is a common complication and is related to worse outcomes. Age, creatinine, and ejection fraction (ACEF) score is a simple scoring method that includes three parameters. Our study aimed to evaluate whether ACEF score could predict the development of AKI in patients who underwent AVR.

Methods: A total of 366 consecutive patients who underwent isolated AVR for symptomatic severe aortic stenosis were evaluated retrospectively. The development of AKI was the primary endpoint of the study. The ACEF score was calculated by the formula: age (years)/left ventricular ejection fraction (%) + 1 (if baseline serum creatinine was >2 mg/dL). According to the ACEF score the study population was divided into two groups.

Results: AKI was developed in 66 (18%) patients. The cut-off value of the ACEF score for the prediction of AKI was 1.07 with a sensitivity of 69.7% and a specificity of 56.7% (AUC 0.663; 95% CI: 0.589-0.736; P<0.001). AKI incidence was found to be higher in patients with high ACEF score than low ACEF score [46 (26.1%) vs. 20 (10.5%); P<0.001]. In addition, ACEF score [OR: 2.599; 95% CI: 1.399-4.828; P=0.002] and hemoglobin levels (OR: 0.837; 95% CI: 0.729-0.961; P=0.012) were found to be independent predictors of AKI.

Conclusions: Our study revealed that the ACEF score is an independent predictor of AKI. ACEF score, as a simple and objective score, can be useful in predicting AKI in patients undergoing AVR.

Keywords

Acute kidney injury, aortic stenosis, aortic valve replacement, predictors, ACEF score

References

1. Kang DH, Park SJ, Lee SA, et al. Early surgery or conservative care for asymptomatic aortic stenosis. N Engl J Med. 2020;382(2):111-119. doi: 10.1056/NEJMoa1912846.
2. Turina J, Hess O, Sepulcri F, Krayenbuehl HP. Spontaneous course of aortic valve disease. Eur Heart J. 1987;8(5):471-483. doi: 10.1093/oxfordjournals.eurheartj.a062307.
3. VARC-3 WRITING COMMITTEE; Généreux P, Piazza N, Alu MC, et al. Valve Academic Research Consortium 3: updated endpoint definitions for aortic valve clinical research. J Am Coll Cardiol. 2021;77(21):2717-2746. doi: 10.1016/j.jacc.2021.02.038.
4. Yildiz I, Yildiz PO, Rencuzogullari I, et al. Association of serum osmolarity with contrast-induced nephropathy in patients with ST-segment elevation myocardial infarction. Angiology. 2019;70(7):627-632. doi: 10.1177/0003319719826466.
5. Karabağ Y, Çağdaş M, Rencuzogullari I, et al. The C-reactive protein to albumin ratio predicts acute kidney injury in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Heart Lung Circ. 2019;28(11):1638-1645. doi: 10.1016/j.hlc.2018.08.009.
6. Kumar N, Garg N. Acute kidney injury after aortic valve replacement in a nationally representative cohort in the USA. Nephrol Dial Transplant. 2019;34(2):295-300. doi: 10.1093/ndt/gfy097.
7. Ranucci M, Castelvecchio S, Menicanti L, Frigiola A, Pelissero G. Risk of assessing mortality risk in elective cardiac operations: age, creatinine, ejection fraction, and the law of parsimony. Circulation. 2009;119(24):3053-3061. doi: 10.1161/CIRCULATIONAHA.108.842393.
8. Chang CH, Lee CC, Chen SW, et al. Predicting acute kidney injury following mitral valve repair. Int J Med Sci. 2016;13(1):19-24. doi: 10.7150/ijms.13253.
9. Chen SW, Chang CH, Fan PC, et al. Comparison of contemporary preoperative risk models at predicting acute kidney injury after isolated coronary artery bypass grafting: a retrospective cohort study. BMJ Open. 2016;6(6):e010176. doi: 10.1136/bmjopen-2015-010176.
10. Andò G, Morabito G, de Gregorio C, Trio O, Saporito F, Oreto G. Age, glomerular filtration rate, ejection fraction, and the AGEF score predict contrast-induced nephropathy in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention. Catheter Cardiovasc Interv. 2013;82(6):878-885. doi: 10.1002/ccd.25023.
11. Uygur B, Celik O, Demir AR, et al. A simplified acute kidney injury predictor following transcatheter aortic valve implantation: ACEF score. Kardiol Pol. 2021;79(6):662-668. doi: 10.33963/KP.15933.
12. Rana M. Aortic valve stenosis: diagnostic approaches and recommendations of the 2021 ESC/EACTS guidelines for the management of valvular heart disease -A review of the literature. Cardiol Cardiovasc Med. 2022;6(3):315-324. doi: 10.26502/fccm.92920267.
13. Hirji SA, Funamoto M, Lee J, et al. Minimally invasive versus full sternotomy aortic valve replacement in low-risk patients: Which will stand against transcatheter aortic valve replacement? Surgery. 2018;164(2):282-287. doi: 10.1016/j.surg.2018.02.018.
14. Cockcroft DW, Gault MH. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31-41. doi: 10.1159/000180580.
15. Wykrzykowska JJ, Garg S, Onuma Y, et al. Value of age, creatinine, and ejection fraction (ACEF score) in assessing risk in patients undergoing percutaneous coronary interventions in the 'All-Comers' LEADERS trial. Circ Cardiovasc Interv. 2011;4(1):47-56. doi: 10.1161/CIRCINTERVENTIONS.110.958389.
16. Parolari A, Pesce LL, Pacini D, et al; Monzino Research Group on Cardiac Surgery Outcomes. Risk factors for perioperative acute kidney injury after adult cardiac surgery: role of perioperative management. Ann Thorac Surg. 2012;93(2):584-591. doi: 10.1016/j.athoracsur.2011.09.073.
17. Brown JR, Kramer RS, Coca SG, Parikh CR. Duration of acute kidney injury impacts long-term survival after cardiac surgery. Ann Thorac Surg. 2010;90(4):1142-1148. doi: 10.1016/j.athoracsur.2010.04.039.
18. Englberger L, Suri RM, Li Z, et al. Clinical accuracy of RIFLE and Acute Kidney Injury Network (AKIN) criteria for acute kidney injury in patients undergoing cardiac surgery. Crit Care. 2011;15(1):R16. doi: 10.1186/cc9960.
19. Hobson CE, Yavas S, Segal MS, et al. Acute kidney injury is associated with increased long-term mortality after cardiothoracic surgery. Circulation. 2009;119(18):2444-2453. doi: 10.1161/CIRCULATIONAHA.108.800011.
20. Grayson AD, Khater M, Jackson M, Fox MA. Valvular heart operation is an independent risk factor for acute renal failure. Ann Thorac Surg. 2003;75(6):1829-1835. doi: 10.1016/s0003-4975(03)00166-8.
21. Najjar M, Salna M, George I. Acute kidney injury after aortic valve replacement: incidence, risk factors and outcomes. Expert Rev Cardiovasc Ther. 2015;13(3):301-316. doi: 10.1586/14779072.2015.1002467.
22. Araujo GN, Pivatto Junior F, Fuhr B, et al. Simplifying contrast-induced acute kidney injury prediction after primary percutaneous coronary intervention: the age, creatinine and ejection fraction score. Cardiovasc Interv Ther. 2018;33(3):224-231. doi: 10.1007/s12928-017-0472-y.
23. Laurent M, Fournet M, Feit B, et al. Simple bedside clinical evaluation versus established scores in the estimation of operative risk in valve replacement for severe aortic stenosis. Arch Cardiovasc Dis. 2013;106(12):651-660. doi: 10.1016/j.acvd.2013.09.001.
24. Thakar CV. Perioperative acute kidney injury. Adv Chronic Kidney Dis. 2013;20(1):67-75. doi: 10.1053/j.ackd.2012.10.003.
25. Hertzberg D, Sartipy U, Lund LH, Rydén L, Pickering JW, Holzmann MJ. Heart failure and the risk of acute kidney injury in relation to ejection fraction in patients undergoing coronary artery bypass grafting. Int J Cardiol. 2019;274:66-70. doi: 10.1016/j.ijcard.2018.09.092.
26. Callejas R, Panadero A, Vives M, Duque P, Echarri G, Monedero P; Renal Dysfunction in Cardiac Surgery Spanish Group (GEDRCC2). Preoperative predictive model for acute kidney injury after elective cardiac surgery: a prospective multicenter cohort study. Minerva Anestesiol. 2019;85(1):34-44. doi: 10.23736/S0375-9393.18.12257-7.

There are 26 citations in total.

Details

Primary Language	English
Subjects	Cardiology
Journal Section	Original Articles
Authors	Gökhan Demirci 0000-0003-2835-7530 Ali Rıza Demir 0000-0002-3776-0228 Serkan Kahraman 0000-0003-2796-0987 Sencer Çamcı 0000-0003-2152-0470 Emre Yılmaz 0000-0002-1656-3778
Early Pub Date	December 21, 2023
Publication Date	May 4, 2024
Submission Date	August 4, 2023
Acceptance Date	October 20, 2023
Published in Issue	Year 2024 Volume: 10 Issue: 3

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AMA	Demirci G, Demir AR, Kahraman S, Çamcı S, Yılmaz E. Predictive value of ACEF score for acute kidney injury after surgical aortic valve replacement. Eur Res J. May 2024;10(3):254-261. doi:10.18621/eurj.1334048

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