Abstract 15231: Relationship Between Severe Aortic Stenosis, Chronic Kidney Disease, and Clinical Outcomes in Patients With Aortic Stenosis

Introduction:Patients with chronic kidney disease (CKD) often have cardiovascular calcification with a higher prevalence of AV disease. Aortic valve calcium (AVC) scores are often used to assess the severity of aortic stenosis (AS).Methods:We retrospectively studied 361 patients with AS who underwent a CTA at our institute from Nov 2018 to Mar 2022. GFR values closest to the CTA, but at most three months prior, along with the occurrence of the following outcomes: TAVR, SAVR, and all-cause mortality were recorded. An AVC score > 2000 for men and 1200 for women was defined as severe AS. Also, GFR values were split into 3 groups: >=60 (Group 1), 30-59 (Group 2), and <30 (Group 3). An interaction term (CKD x AS) was also used to evaluate the differential impact of severe AS on outcomes within the CKD groups.Results:There was no significant difference in AVC scores among the CKD groups (p = 0.21) using a Kruskal-Wallis test. However, severe AS was associated with a higher occurrence of outcomes (OR = 6.84 [1.67 - 27.96], p = 0.008*), along with a non-significant interaction term (OR = 0.63 [0.26 - 1.52], p = 0.3) using a logistic regression with severe AS, CKD groups, and the interaction term as independent variables. Moreover, using a cox proportional-hazards model with the same variables, severe AS had a significant association with the outcomes (HR = 2.51, p = 0.009*), with a non-significant interaction term (HR = 0.85, p = 0.43).Conclusions:There was no significant difference in AVC scores among the CKD groups. But irrespective of kidney function, severe AS was associated with worse outcomes. Therefore, similar thresholds of AVC scores can be used to define severe AS in patients with and without CKD.