Yasin Özen, Hüseyin Tezcan, Halil Özalp, Adnan Karaibrahimoglu, Kaan Burak Yildiz, Mevlüt Serdar Kuyumcu, Abdullah Tunçez, Kadri Murat Gürses, Mustafa Bilal Özbay, Ahmet Göktuğ Ertem, MUHAMMED ULVİ YALÇIN, Nazif Aygül
Transcatheter aortic valve replacement (TAVR) is being performed in increasingly complex, high-risk cohorts, and contrast-induced nephropathy (CIN) remains a major determinant of morbidity and mortality. The endothelial-damage score EASIX (lactate dehydrogenase × creatinine/platelet count) is a validated prognostic index in hematology and critical care but has never been explored after TAVR. We retrospectively analyzed 130 consecutive severe AC patients (mean age 76.8 ± 8.4 years; 47.8% male) who underwent transfemoral TAVR (February 2019-March 2021). CIN was defined as a ≥25% or ≥0.5 mg/dL creatinine rise within 72 hours. The predictive value of EASIX was assessed with receiver operating characteristic analysis and multivariable logistic regression. CIN occurred in 15.4% (n = 20). Baseline EASIX was higher in CIN+ vs CIN- (2.92 ± 1.28 vs 1.33 ± 1.30; P < .001). An EASIX threshold ≥ 1.904 predicted CIN with 90.3% sensitivity and 86.2% specificity (area under the curve 0.91; P < .001). In multivariable analysis, EASIX (OR 2.62; P = .023), contrast volume, and baseline eGFR independently predicted CIN. EASIX, obtainable from routine laboratories, is an independent, high-performance predictor of CIN after TAVR and may facilitate pre-procedural risk stratification.