Abstract 14756: Outcomes of Cardiac Co-Morbidities in Renal Transplantation: A National Population-Based Cohort Study

Abstract

Background Cardiovascular disease (CVD) is common and associated with higher mortality in end-stage renal disease patients, but its impact on mortality from renal transplantation has not been studied formally. Our aim was to investigate the impact of CVD on the mortality of renal transplant recipients at the time of transplantation. Methods The National Inpatient Sample 2016-2019 was analyzed to identify a patient cohort admitted for renal transplantation with a diagnosis of a cardiovascular diseases using ICD-10 codes. The prevalence of various cardiac co-morbidities and their effect on mortality in renal transplant recipients were evaluated. A multivariate logistic regression model was used to analyze the in-hospital mortality rates. Results Analysis of 142,333,352 patients revealed that 84,525 (0.059%) were admitted for renal transplantation, of whom 32.5% had cardiac co-morbidities. Mean age of these patients was 57 years, and 66% were males. 19% of these patients had ischemic heart disease, 15.9% had heart block, 8.1% had heart failure, 7.1% had atrial fibrillation, 7.6% had congenital heart disease (CHD), 3.4% had pulmonary hypertension, 2.7% had ventricular arrhythmia, 2.5% had non-rheumatic valvular heart disease (NRVHD), 1.3% had chronic rheumatic heart disease (CRHD), 0.05% had pericarditis, and 0.018% had infective endocarditis. In patients undergoing renal transplant, CVD was associated with more than four times higher likelihood of mortality (OR 4.77, CI 2.84-8.03, p=0.00). Pericarditis (OR 31.56), ventricular arrhythmia (OR 13.9), heart failure (OR 5.4), heart block (OR 5.0), atrial fibrillation (OR 2.64), pulmonary hypertension (OR 2.54), and ischemic heart disease (OR 1.7) were also associated with significantly higher mortality (p<0.05). CHD, NRVHD, CRHD, and infective endocarditis had no significant association with mortality. Conclusions The prevalence of CVD in renal transplant recipients is 32.5%, and it is associated with over four-fold higher odds of mortality. Other cardiac co-morbidities associated with increased mortality following renal transplantation are ischemic heart disease, heart failure, atrial fibrillation, ventricular arrhythmia, heart block, pericarditis, and pulmonary hypertension