Background: In patients undergoing transcatheter aortic valve replacement (TAVR), the impact of acute kidney injury (AKI) on the prognosis and especially on future kidney function has been sparsely examined, and data from large cohorts are warranted. Methods and Results: With Danish nationwide registries, we identified all patients undergoing TAVR from 2014 to 2021 with no previous dialysis treatment. According to 2 plasma creatinine samples, we identified those suffering a postprocedural AKI within 21 days after TAVR. With 1 year of follow‐up, we compared the associated rates of dialysis treatment and death between patients with and without an AKI using multivariable Cox analysis. Finally, according to the lowest recorded creatinine sample, we assessed the kidney function among AKI survivors between 90 and 180 days after the index date. We identified 4091 TAVRs: 193 (4.7%) with AKI (55.4% men; median age, 82 years) and 3898 (95.3%) without AKI (57.0% men; median age, 81 years). Compared with those without AKI, patients with AKI showed increased associated 1‐year rates of dialysis treatment (hazard ratio [HR], 7.20 [95% CI, 4.10–12.66]) and death (HR, 2.39 [95% CI, 1.59–3.58]). After 6 months, 74% of AKI survivors had complete kidney recovery, 14.7% had incomplete kidney recovery, 6.3% failed to recover, and 5.1% were on dialysis treatment. Conclusions: We identified that AKI after TAVR was associated with an increased rate of future dialysis treatment and all‐cause death. Among survivors, 74% had complete kidney recovery within 6 months.

Aims: To describe the practice patterns of evidence-based medical therapy (EBM) and overall mortality in high-risk patients with critical limb-threatening ischaemia (CLTI), compared with patients with myocardial infarction (MI). Methods and results: Using Danish registries, we identified patients 40–100 years of age with a first-time hospitalization for CLTI or MI from 2008–2018 and grouped them into CLTI, MI, and CLTI and history of MI (CLTI + MI). We examined the likelihood of filling prescriptions with EBM [i.e. antiplatelets (Aps), lipid-lowering agents (LLAs), angiotensin-converting enzyme inhibitor (ACEi), or angiotensin II-receptor blockers (ARBs)] within 3 months after discharge among survivors. Further, we assessed the adjusted 3-year mortality rates. We included 92 845 patients: 14 941 with CLTI (54.7% male), 74 830 with MI (64.6% male) and 3,074 with CLTI + MI (65.2% male). Patients with CLTI and CLTI + MI were older and had more comorbidities than patients with MI. Compared with patients with MI, the unadjusted odds ratios of filling prescriptions were 0.15 [confidence interval (CI): 0.14–0.15] for AP, 0.26 (CI: 0.25–0.27) for LLA, and 0.71 (CI: 0.69–0.74) for ARB/ACEi in patients with CLTI, and 0.22 (CI: 0.20–0.24) for AP, 0.38 (CI: 0.35–0.42) for LLA, and 1.17 (CI: 1.08–1.27) for ARB/ACEi in patients with CLTI + MI. Adjusted analyses showed similar results. Compared with patients with MI, adjusted 3-year hazard ratios for mortality were 1.69 (CI: 1.64–1.74) in patients with CLTI and 1.60 (CI: 1.51–1.69) in patients with CLTI + MI. Conclusion: Patients with CLTI were undertreated with EBM and carried a more adverse prognosis, as compared with patients with MI, despite similar guidelines.

This nationwide, retrospective, registry study aimed to evaluate the rate of continued opioid use after revascularisation in patients with lower extremity peripheral artery disease (PAD) and to examine the association between opioid treatment and post-discharge all cause mortality. Using Danish national registries, all patients undergoing first time endovascular or surgical revascularisation for PAD between 1996 - 2018 were identified. Patients were categorised based on opioid use prior to admission as: (1) current new users (first time opioid prescription within 30 days before admission), (2) current long term users (opioid prescription both before and within 30 days before admission), (3) recent users (prescription within 31 - 365 days before admission), (4) former users (prescription > 1 year before), and (5) non-users (no history of opioid prescription). Outcomes post-discharge were analysed using multivariable Cox regression. Among 40 186 patients (median age 70 years, 54% men) surviving revascularisation, 5.4% were current new users, 22.9% current long term users, 14.5% recent users, 19.0% former users, and 38.2% non-users. A higher proportion of opioid users presented with chronic limb threatening ischaemia. Within 3 months post-discharge, opioid prescription refills were highest among current long term users (76.7%) and lowest among non-users (14.6%). Compared with non-users, the 1 year adjusted hazard ratio for all cause mortality was 1.64 (95% CI 1.44 - 1.86) for current new users, 1.59 (95% CI 1.46 - 1.74) for current long term users, and 1.13 (95% CI 1.03 - 1.26) for recent users, with no significant increase in risk for former users. This nationwide study identified a high risk subgroup of PAD patients with substantial opioid use and elevated mortality risk. Despite revascularisation, many with prior opioid use continued treatment post-discharge, highlighting the need for cautious prescribing and structured follow up to manage persistent pain and complex care needs. Although causality cannot be confirmed, pre-revascularisation opioid use was associated with higher all cause mortality, likely reflecting greater disease severity.