Published online Feb 24, 2017. doi: 10.5500/wjt.v7.i1.49
Peer-review started: August 26, 2016
First decision: October 20, 2016
Revised: December 14, 2016
Accepted: January 2, 2017
Article in press: January 4, 2017
Published online: February 24, 2017
Processing time: 180 Days and 13.4 Hours
To investigate the incidence and the determinants of cardiovascular morbidity in Greek renal transplant recipients (RTRs) expressed as major advance cardiac event (MACE) rate.
Two hundred and forty-two adult patients with a functioning graft for at least three months and available data that were followed up on the August 31, 2015 at two transplant centers of Western Greece were included in this study. Baseline recipients’ data elements included demographics, clinical characteristics, history of comorbid conditions and laboratory parameters. Follow-up data regarding MACE occurrence were collected retrospectively from the patients’ records and MACE risk score was calculated for each patient.
The mean age was 53 years (63.6% males) and 47 patients (19.4%) had a pre-existing cardiovascular disease (CVD) before transplantation. The mean estimated glomerular filtration rate was 52 ± 17 mL/min per 1.73 m2. During follow-up 36 patients (14.9%) suffered a MACE with a median time to MACE 5 years (interquartile range: 2.2-10 years). Recipients with a MACE compared to recipients without a MACE had a significantly higher mean age (59 years vs 52 years, P < 0.001) and a higher prevalence of pre-existing CVD (44.4% vs 15%, P < 0.001). The 7-year predicted mean risk for MACE was 14.6% ± 12.5% overall. In RTRs who experienced a MACE, the predicted risk was 22.3% ± 17.1% and was significantly higher than in RTRs without an event 13.3% ± 11.1% (P = 0.003). The discrimination ability of the model in the Greek database of RTRs was good with an area under the receiver operating characteristics curve of 0.68 (95%CI: 0.58-0.78).
In this Greek cohort of RTRs, MACE occurred in 14.9% of the patients, pre-existing CVD was the main risk factor, while MACE risk model was proved a dependable utility in predicting CVD post RT.
Core tip: Cardiovascular disease being the leading cause of death with a functioning graft following renal transplantation. The aim of this study was to investigate the incidence and the determinants of cardiovascular morbidity in prevalent Greek renal transplant recipients (RTRs) expressed as major adverse cardiac event (MACE) rate. Additionally, we examined the applicability of a recently developed risk prediction model in our population. According to our results older age of recipient and pre-existing cardiovascular disease were the main risk factors for MACE. The applied risk model can be used for risk stratification in this database of RTRs.