Early cardiovascular events and cardiovascular death after renal transplantation: role of pretransplant risk factors

Background The purpose of this study was to verify the risk factors present in patients on the kidney transplant waiting list that may interfere with the incidence of cardiovascular (CV) events and death during the first 12 months after transplantation. Methods Based on the data collected prospectiv...

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Bibliographic Details
Published in:Clinical and experimental nephrology 2021-05, Vol.25 (5), p.545-553
Main Authors: De Lima, Jose Jayme G., Gowdak, Luis Henrique W., David-Neto, Elias, Bortolotto, Luiz A.
Format: Article
Language:English
Subjects:
Angina
Angina pectoris
Cardiovascular disease
Coronary artery
Death
Diabetes mellitus
Heart diseases
Hypertrophy
Ischemia
Kidney transplantation
Medicine
Medicine & Public Health
Myocardial ischemia
Nephrology
Original Article
Risk factors
Transplants & implants
Urology
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Summary:Background The purpose of this study was to verify the risk factors present in patients on the kidney transplant waiting list that may interfere with the incidence of cardiovascular (CV) events and death during the first 12 months after transplantation. Methods Based on the data collected prospectively during pretransplant workups , a retrospective study was conducted including 665 patients followed up until death or completing 12 months posttransplantation. Endpoints were the composite incidence of CV events and death. Results The prevalence of diabetes, LV hypertrophy, and CV disease at baseline was high; 14% of patients had angina, 26% an abnormal myocardial scan, and 47% coronary artery disease. CV events occurred in 53 patients (8.4%) and in 29 (55%) caused death. The independent predictors of events were age ≥ 50 years (HR 2.292; CI% 1.093–4.806), angina (HR 1.969; CI% 1.039–3.732), and altered myocardial scan (HR 1.905, CI% 1.059–3.428). Altered myocardial scan (HR 2.822, 95% CI 1.095–6.660) was also one of the independent predictor of CV death. Conclusion The incidence of CV events and death were predicted by variables associated with myocardial ischemia, a potentially modifiable risk factor. Patients with pretransplantation myocardial ischemia should be considered at a higher risk of developing early CV complications and managed accordingly before, during, and after kidney transplantation.
ISSN:1342-1751
1437-7799
DOI:10.1007/s10157-021-02019-6