{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T12:45:39Z","timestamp":1769085939181,"version":"3.49.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,5]],"date-time":"2025-12-05T00:00:00Z","timestamp":1764892800000},"content-version":"vor","delay-in-days":1278,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T00:00:00Z","timestamp":1654473600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>No study has evaluated the prognostic value of the chronic kidney disease (CKD) classification by cystatin C-based estimated glomerular filtration rate (eGFR) (CKDCys classification) in patients undergoing transcatheter aortic valve replacement (TAVR). This study aimed to compare the prognostic value of CKDCys classification and CKD classification by creatinine-based eGFR (CKDCr classification) in risk prediction after TAVR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>We retrospectively analysed consecutive 219 patients with symptomatic severe aortic stenosis who underwent TAVR at our institute between December 2016 and June 2019. Pre-operative CKDCr and CKDCys classifications were evaluated for their prognostic value of 2-year major adverse cardiovascular and cerebrovascular events (MACCE) after TAVR. MACCE was defined as the composite of all-cause mortality, non-fatal myocardial infarction, stroke, and rehospitalization for worsening congestive heart failure. Participants had a median age of 86.0 years and were predominantly female (76.9%). In 96.6% of the cases, TAVR was performed using transfemoral access. The median creatinine-based eGFR (52.85 mL\/min\/1.73 m2) was higher than the cystatin C-based eGFR (41.50 mL\/min\/1.73 m2). Downward reclassification in CKD stages based on eGFRCys was observed in 49.0% of patients. During a median follow-up period of 575.5 (interquartile range: 367.0\u2013730.0) days, 58 patients presented with MACCE. CKDCys classification, but not CKDCr classification, significantly stratified the risk of 2-year MACCE in patients after TAVR by log-rank test (P = 0.003). In multivariate Cox regression analysis, only CKDCys stage 3b [hazard ratio (HR) = 4.37; 95% confidence interval (CI): 1.28\u201314.91; P = 0.019] and CKDCys stage 4 + 5 (HR = 3.72; 95% CI: 1.06\u201312.99; P = 0.040) were significant predictors of MACCE after adjustment for potential confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The CKDCys classification could better assess the risk than the CKDCr classification in patients undergoing TAVR. CKDCys stage 3b and stage 4 + 5 correlated with adverse outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ehf2.13977","type":"journal-article","created":{"date-parts":[[2022,6,6]],"date-time":"2022-06-06T08:03:24Z","timestamp":1654502604000},"page":"2601-2609","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Cystatin C in Risk Prediction After Transcatheter Aortic Valve Replacement: A Retrospective Analysis"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6238-0040","authenticated-orcid":false,"given":"Kensuke","family":"Kuwabara","sequence":"first","affiliation":[{"name":"Department of Cardiology, Kishiwada Tokushukai Hospital , Kishiwada ,","place":["Japan"]},{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kan","family":"Zen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masaki","family":"Yashige","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuaki","family":"Takamatsu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuyasu","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshito","family":"Kadoya","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michiyo","family":"Yamano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsuhiro","family":"Yamano","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Nakamura","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Yaku","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoaki","family":"Matoba","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine , Kyoto ,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,6,6]]},"reference":[{"key":"2026012114143432700_ehf213977-bib-0001","doi-asserted-by":"crossref","first-page":"2050","DOI":"10.1016\/j.jcin.2017.07.044","article-title":"Association of chronic kidney disease with in-hospital outcomes of transcatheter aortic valve replacement","volume":"10","author":"Gupta","year":"2017","journal-title":"JACC Cardiovasc Intv"},{"key":"2026012114143432700_ehf213977-bib-0002","doi-asserted-by":"crossref","first-page":"1172","DOI":"10.1016\/j.athoracsur.2016.07.001","article-title":"Impact of preoperative chronic kidney disease in 2,531 high-risk and inoperable patients undergoing transcatheter aortic valve replacement in the PARTNER trial","volume":"102","author":"Thourani","year":"2016","journal-title":"Ann Thorac Surg"},{"key":"2026012114143432700_ehf213977-bib-0003","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1136\/heartjnl-2014-307041","article-title":"Impact of renal function on survival after transcatheter aortic valve implantation (TAVI): an analysis of the UK TAVI registry","volume":"101","author":"Ferro","year":"2015","journal-title":"Heart"},{"key":"2026012114143432700_ehf213977-bib-0004","doi-asserted-by":"crossref","first-page":"869","DOI":"10.1016\/j.jacc.2013.04.057","article-title":"Prognostic value of chronic kidney disease after transcatheter aortic valve implantation","volume":"62","author":"Yamamoto","year":"2013","journal-title":"J Am Coll Cardiol"},{"key":"2026012114143432700_ehf213977-bib-0005","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.4244\/EIJV10I9A183","article-title":"Impact of chronic kidney disease on the outcomes of transcatheter aortic valve implantation: results from the FRANCE 2 registry","volume":"10","author":"Oguri","year":"2015","journal-title":"EuroIntervention"},{"key":"2026012114143432700_ehf213977-bib-0006","doi-asserted-by":"crossref","DOI":"10.1161\/CIRCINTERVENTIONS.114.002220","article-title":"Moderate and severe preoperative chronic kidney disease worsen clinical outcomes after transcatheter aortic valve implantation meta-analysis of 4992 patients","volume":"8","author":"Gargiulo","year":"2015","journal-title":"Circ Cardiovasc Interv"},{"key":"2026012114143432700_ehf213977-bib-0007","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1053\/j.ajkd.2017.03.021","article-title":"Non-GFR determinants of low-molecular-weight serum protein filtration markers in the elderly: AGES-kidney and MESA-kidney","volume":"70","author":"Foster","year":"2017","journal-title":"Am J Kidney Dis"},{"key":"2026012114143432700_ehf213977-bib-0008","doi-asserted-by":"crossref","first-page":"652","DOI":"10.1038\/ki.2008.638","article-title":"Factors other than glomerular filtration rate affect serum cystatin C levels","volume":"75","author":"Stevens","year":"2009","journal-title":"Kidney Int"},{"key":"2026012114143432700_ehf213977-bib-0009","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1053\/ajkd.2001.20628","article-title":"Serum cystatin C concentration as a marker of renal dysfunction in the elderly","volume":"37","author":"Fliser","year":"2001","journal-title":"Am J Kidney Dis"},{"key":"2026012114143432700_ehf213977-bib-0010","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1056\/NEJMoa1214234","article-title":"Cystatin C versus creatinine in determining risk based on kidney function","volume":"369","author":"Shlipak","year":"2013","journal-title":"N Engl J Med"},{"key":"2026012114143432700_ehf213977-bib-0011","doi-asserted-by":"crossref","first-page":"604","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"2026012114143432700_ehf213977-bib-0012","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1053\/j.ajkd.2010.02.344","article-title":"Modification of the CKD epidemiology collaboration (CKD-EPI) equation for Japanese: accuracy and use for population estimates","volume":"56","author":"Horio","year":"2010","journal-title":"Am J Kidney Dis"},{"key":"2026012114143432700_ehf213977-bib-0013","first-page":"1","article-title":"Kidney disease: improving global outcomes (KDIGO) CKD work group. KDIGO 2012 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"3","author":"Levin","year":"2013","journal-title":"Kidney Int Suppl"},{"key":"2026012114143432700_ehf213977-bib-0014","doi-asserted-by":"crossref","first-page":"S45","DOI":"10.1093\/ejcts\/ezs533","article-title":"Updated standardized endpoint definitions for transcatheter aortic valve implantation: the valve academic research consortium-2 consensus document (VARC-2)","volume":"42","author":"Kappetein","year":"2012","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026012114143432700_ehf213977-bib-0015","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1053\/j.ajkd.2020.05.017","article-title":"The difference between cystatin C\u2013and creatinine-based estimated GFR and associations with frailty and adverse outcomes: a cohort analysis of the Systolic Blood Pressure Intervention Trial (Sprint)","volume":"76","author":"Potok","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"2026012114143432700_ehf213977-bib-0016","doi-asserted-by":"crossref","first-page":"896","DOI":"10.1053\/j.ajkd.2020.05.018","article-title":"The difference between cystatin C\u2013and creatinine-based estimated GFR and incident frailty: an analysis of the Cardiovascular Health Study (CHS)","volume":"76","author":"Potok","year":"2020","journal-title":"Am J Kidney Dis"},{"key":"2026012114143432700_ehf213977-bib-0017","doi-asserted-by":"crossref","first-page":"671","DOI":"10.4244\/EIJ-D-19-00110","article-title":"Transcatheter aortic valve replacement outcomes in patients with sarcopaenia","volume":"15","author":"Heidari","year":"2019","journal-title":"EuroIntervention"},{"key":"2026012114143432700_ehf213977-bib-0018","doi-asserted-by":"crossref","first-page":"64","DOI":"10.1007\/s12603-020-1448-7","article-title":"Sarcopenia in patients undergoing transcatheter aortic valve implantation (TAVI): a systematic review of the literature","volume":"25","author":"Bertschi","year":"2021","journal-title":"J Nutr Health Aging"},{"key":"2026012114143432700_ehf213977-bib-0019","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1093\/ndt\/gfh962","article-title":"Relationship of gender, age, and body mass index to errors in predicted kidney function","volume":"20","author":"Cirillo","year":"2005","journal-title":"Nephrol Dial Transplant"},{"key":"2026012114143432700_ehf213977-bib-0020","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1053\/ajkd.2000.8237","article-title":"Serum cystatin C as a new marker for noninvasive estimation of glomerular filtration rate and as a marker for early renal impairment","volume":"36","author":"Coll","year":"2000","journal-title":"Am J Kidney Dis"},{"key":"2026012114143432700_ehf213977-bib-0021","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1056\/NEJMoa041031","article-title":"Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization","volume":"351","author":"Go","year":"2004","journal-title":"N Engl J Med"},{"key":"2026012114143432700_ehf213977-bib-0022","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1161\/CIRCOUTCOMES.113.000221","article-title":"Chronic kidney disease and outcomes in heart failure with preserved versus reduced ejection fraction: the cardiovascular research network PRESERVE study","volume":"6","author":"Smith","year":"2013","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"2026012114143432700_ehf213977-bib-0023","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1053\/j.ajkd.2012.01.016","article-title":"GFR and cardiovascular outcomes after acute myocardial infarction: results from the Korea acute myocardial infarction registry","volume":"59","author":"Bae","year":"2012","journal-title":"Am J Kidney Dis"},{"key":"2026012114143432700_ehf213977-bib-0024","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1093\/ndt\/gfy086","article-title":"Chronic kidney disease staging with cystatin C or creatinine-based formulas: flipping the coin","volume":"34","author":"Luis-Lima","year":"2019","journal-title":"Nephrol Dial Transplant"}],"container-title":["ESC Heart Failure"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ehf2.13977","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ehf2.13977","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/4\/2601\/65349278\/eschf_9_4_2601.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eschf\/article-pdf\/9\/4\/2601\/65349278\/eschf_9_4_2601.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T19:17:15Z","timestamp":1769023035000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eschf\/article\/9\/4\/2601\/8322941"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,6]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022,6,6]]},"published-print":{"date-parts":[[2022,8,1]]}},"URL":"https:\/\/doi.org\/10.1002\/ehf2.13977","relation":{},"ISSN":["2055-5822"],"issn-type":[{"value":"2055-5822","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2022,8]]},"published":{"date-parts":[[2022,6,6]]},"assertion":[{"value":"2021-12-06","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-05-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}