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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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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.
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container_title Clinical and experimental nephrology
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creator De Lima, Jose Jayme G.
Gowdak, Luis Henrique W.
David-Neto, Elias
Bortolotto, Luiz A.
description 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.
doi_str_mv 10.1007/s10157-021-02019-6
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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.</description><identifier>ISSN: 1342-1751</identifier><identifier>EISSN: 1437-7799</identifier><identifier>DOI: 10.1007/s10157-021-02019-6</identifier><identifier>PMID: 33506358</identifier><language>eng</language><publisher>Singapore: Springer Singapore</publisher><subject>Angina ; Angina pectoris ; Cardiovascular disease ; Coronary artery ; Death ; Diabetes mellitus ; Heart diseases ; Hypertrophy ; Ischemia ; Kidney transplantation ; Medicine ; Medicine &amp; Public Health ; Myocardial ischemia ; Nephrology ; Original Article ; Risk factors ; Transplants &amp; implants ; Urology</subject><ispartof>Clinical and experimental nephrology, 2021-05, Vol.25 (5), p.545-553</ispartof><rights>Japanese Society of Nephrology 2021</rights><rights>Japanese Society of Nephrology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-5fcad1a62f340fc0be7ba6f447c2980598380c95c5d37f5ebbac391220b086823</citedby><cites>FETCH-LOGICAL-c454t-5fcad1a62f340fc0be7ba6f447c2980598380c95c5d37f5ebbac391220b086823</cites><orcidid>0000-0002-3310-0484 ; 0000-0002-6785-7506 ; 0000-0002-4865-6442 ; 0000-0003-4981-3689</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33506358$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>De Lima, Jose Jayme G.</creatorcontrib><creatorcontrib>Gowdak, Luis Henrique W.</creatorcontrib><creatorcontrib>David-Neto, Elias</creatorcontrib><creatorcontrib>Bortolotto, Luiz A.</creatorcontrib><title>Early cardiovascular events and cardiovascular death after renal transplantation: role of pretransplant risk factors</title><title>Clinical and experimental nephrology</title><addtitle>Clin Exp Nephrol</addtitle><addtitle>Clin Exp Nephrol</addtitle><description>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. 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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. 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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
title Early cardiovascular events and cardiovascular death after renal transplantation: role of pretransplant risk factors
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