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dc.contributor.authorElmariah, Sammyen_US
dc.contributor.authorFarrell, Laurie A.en_US
dc.contributor.authorDaher, Maureenen_US
dc.contributor.authorShi, Xuen_US
dc.contributor.authorKeyes, Michelle J.en_US
dc.contributor.authorCain, Carolyn H.en_US
dc.contributor.authorPomerantsev, Eugeneen_US
dc.contributor.authorVlahakes, Gus J.en_US
dc.contributor.authorInglessis, Ignacioen_US
dc.contributor.authorPasseri, Jonathan J.en_US
dc.contributor.authorPalacios, Igor F.en_US
dc.contributor.authorFox, Caroline S.en_US
dc.contributor.authorRhee, Eugene P.en_US
dc.contributor.authorGerszten, Robert E.en_US
dc.date.accessioned2016-08-09T14:52:40Z
dc.date.issued2016en_US
dc.identifier.citationElmariah, S., L. A. Farrell, M. Daher, X. Shi, M. J. Keyes, C. H. Cain, E. Pomerantsev, et al. 2016. “Metabolite Profiles Predict Acute Kidney Injury and Mortality in Patients Undergoing Transcatheter Aortic Valve Replacement.” Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease 5 (3): e002712. doi:10.1161/JAHA.115.002712. http://dx.doi.org/10.1161/JAHA.115.002712.en
dc.identifier.issn2047-9980en
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:27822168
dc.description.abstractBackground: Acute kidney injury (AKI) occurs commonly after transcatheter aortic valve replacement (TAVR) and is associated with markedly increased postoperative mortality. We previously identified plasma metabolites predictive of incident chronic kidney disease, but whether metabolite profiles can identify those at risk of AKI is unknown. Methods and Results: We performed liquid chromatography–mass spectrometry–based metabolite profiling on plasma from patients undergoing TAVR and subjects from the community‐based Framingham Heart Study (N=2164). AKI was defined by using the Valve Academic Research Consortium‐2 criteria. Of 44 patients (mean age 82±9 years, 52% female) undergoing TAVR, 22 (50%) had chronic kidney disease and 9 (20%) developed AKI. Of 85 metabolites profiled, we detected markedly concordant cross‐sectional metabolic changes associated with chronic kidney disease in the hospital‐based TAVR and Framingham Heart Study cohorts. Baseline levels of 5‐adenosylhomocysteine predicted AKI after TAVR, despite adjustment for baseline glomerular filtration rate (odds ratio per 1‐SD increase 5.97, 95% CI 1.62–22.0; P=0.007). Of the patients who had AKI, 6 (66.7%) subsequently died, compared with 3 (8.6%) deaths among those patients who did not develop AKI (P=0.0008) over a median follow‐up of 7.8 months. 5‐adenosylhomocysteine was predictive of all‐cause mortality after TAVR (hazard ratio per 1‐SD increase 2.96, 95% CI 1.33–6.58; P=0.008), independent of baseline glomerular filtration rate. Conclusions: In an elderly population with severe aortic stenosis undergoing TAVR, metabolite profiling improves the prediction of AKI. Given the multifactorial nature of AKI after TAVR, metabolite profiles may identify those patients with reduced renal reserve.en
dc.language.isoen_USen
dc.publisherJohn Wiley and Sons Inc.en
dc.relation.isversionofdoi:10.1161/JAHA.115.002712en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC4943248/pdf/en
dash.licenseLAAen_US
dc.subjectaortic stenosisen
dc.subjectkidneyen
dc.subjectmetabolomicsen
dc.subjectmortalityen
dc.subjecttranscatheter aortic valve implantationen
dc.subjectAortic Valve Replacement/Transcather Aortic Valve Implantationen
dc.subjectBiomarkersen
dc.titleMetabolite Profiles Predict Acute Kidney Injury and Mortality in Patients Undergoing Transcatheter Aortic Valve Replacementen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalJournal of the American Heart Association: Cardiovascular and Cerebrovascular Diseaseen
dash.depositing.authorElmariah, Sammyen_US
dc.date.available2016-08-09T14:52:40Z
dc.identifier.doi10.1161/JAHA.115.002712*
dash.authorsorderedfalse
dash.contributor.affiliatedPomerantsev, Eugene
dash.contributor.affiliatedVlahakes, Gus
dash.contributor.affiliatedElmariah, Sammy
dash.contributor.affiliatedPalacios, Igor
dash.contributor.affiliatedRhee, Eugene
dash.contributor.affiliatedGerszten, Robert
dash.contributor.affiliatedPasseri, Jonathan


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