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PLoS One. 2015 Jun 24;10(6):e0131237. doi: 10.1371/journal.pone.0131237. eCollection 2015.

Prevalence and predictors of early cardiovascular events after kidney transplantation: evaluation of pre-transplant cardiovascular work-up.

Author information

1
Department of Nephrology and Transplantation, Hôpital Necker Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
2
Department of Cardiology, Hôpital Necker, APHP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
3
Department of Biostatistics, Hôpital Necker, APHP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
4
Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France; Department of Clinical Research, Hôpital Necker, APHP, Paris, France.
5
Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France; Department of Functional Explorations, Hôpital Necker, APHP, Paris, France.

Abstract

INTRODUCTION:

Cardiovascular disease is the leading cause of mortality after renal transplantation. The purpose of this study was to analyze cardiovascular risk factors at transplantation, occurrence of cardiovascular events in the first year after transplantation and evaluate pre-transplant work-up.

MATERIAL AND METHOD:

In total, 244 renal transplant recipients older than 50 years were included. The results of pre-transplant work-up, including clinical evaluation, electrocardiogram, echocardiography, myocardial perfusion testing and coronary angiography were analyzed.

RESULTS:

Patients had multiple risk factors at inclusion on renal transplantation waiting list as high blood pressure (94.7%), dyslipidemia (81.1%), smoking (45.3%), diabetes (23.6%), past history of cardiovascular disease (21.3%) and obesity (12.7%). Following transplantation, 15.5% (n = 38) of patients experienced a cardiovascular event, including 2.8% (n = 7) acute coronary syndrome, 5.8% (n = 14) isolated increase in troponin level and 5.3% (n = 13) new onset atrial fibrillation. The pre-transplant parameters associated with a cardiovascular event were a past medical history of cardiovascular disease (HR = 2.06 [1.06-4.03], p = 0.03), echocardiographic left ventricular hypertrophy (HR = 2.04 [1.04-3.98], p = 0.037) and abnormal myocardial perfusion testing (HR = 2.25 [1.09 -5.96], p = 0.03). Pre-transplantation evaluation allowed the diagnosis of unknown coronary artery lesions in 8.9% of patients.

PMID:
26107641
PMCID:
PMC4481263
DOI:
10.1371/journal.pone.0131237
[Indexed for MEDLINE]
Free PMC Article

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