Abstract
BackgroundThe high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients.MethodsAn observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981–2011 was completed. Competing risk survival analysis methods were applied to estimate the cumulative incidence of developing cardiovascular events over time and to identify which characteristics were associated with the risk of these events.Post-transplant cardiovascular events are defined as the presence of myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances, peripheral vascular disease and cardiovascular disease and death. The cause of death was identified through the medical history and death certificate using ICD9 (390–459, except: 427.5, 435, 446, 459.0).ResultsThe mean age of patients at the time of transplantation was 47.0 ± 14.2 years; 62% were male. 16.5% had suffered some cardiovascular disease prior to transplantation and 9.7% had suffered a cardiovascular event. The mean follow-up period for the patients with cardiovascular event was 3.5 ± 4.3 years. Applying competing risk methodology, it was observed that the accumulated incidence of the event was 5.0% one year after transplantation, 8.1% after five years, and 11.9% after ten years. After applying multivariate models, the variables with an independent effect for predicting cardiovascular events are: male sex, age of recipient, previous cardiovascular disorders, pre-transplant smoking and post-transplant diabetes.ConclusionsThis study makes it possible to determine in kidney transplant patients, taking into account competitive events, the incidence of post-transplant cardiovascular events and the risk factors of these events. Modifiable risk factors are identified, owing to which, changes in said factors would have a bearing of the incidence of events.
Highlights
The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality
Some authors have documented a significant reduction in cardiovascular death after kidney transplantation [2], today cardiovascular disease is still the major known cause of death in kidney transplant patients [3]
Conventional cardiovascular risk factors such as hyperlipidaemia, hypertension and diabetes are common in transplant recipients, partly because of the effects of immunosuppressive drugs, and are associated with adverse outcomes [5, 6]
Summary
The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients. Cardiovascular disease is one of the most common complications after renal transplantation [1]. Long-term graft failure is secondary to chronic allograft nephropathy, recurrent disease, and death with a functioning graft. Recurrent disease is becoming an important cause of late graft failure and cardiovascular illnesses and neoplasms are the two main causes of death with normal function of the graft in the long-term follow-up of kidney transplant patients [4]. Determining the incidence of cardiovascular events after a kidney transplant and the associated risk factors is important to inform physicians of the need of cardiovascular disease screening and prevention as part of the transplant evaluation [7, 8]. An accurate estimation of a patient’s risk of cardiovascular disease could allow identifying people at risk of a cardiovascular event and intervene before they develop the disease
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
