Cardiovascular events following renal transplantation: Role of traditional and transplant-specific risk factors

Angelo M DeMattos, J. Prather, A. J. Olyaei, Y. Shibagaki, D. S. Keith, M. Mori, D. J. Norman, T. Becker

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96 Scopus citations

Abstract

Cardiovascular mortality is increased in transplant recipients. However, studies including non-fatal events are critical to assess the burden of disease and to identify novel risk factors. We described the incidence of fatal and non-fatal events, and explored associations and interactions among traditional and transplant-specific risk factors and cardiovascular events (CVE) in a cohort of 922 patients transplanted between 1993 and 1998. One hundred and seventy-six patients experienced 201 CVE (111 cardiac, 48 cerebrovascular, 42 peripheral-vascular). Most CVE were non-fatal. Factors associated with cardiac events were (adjusted hazard ratios) tobacco (3.53; P<0.001), obesity (2.92; P<0.001), diabetes (2.63; P<0.001), multiple rejections (2.19; P=0.008), prior CVE (2.0; P=0.004), dialysis >1 year (1.91; P=0.007), and overweight status (1.68; P=0.04); with cerebrovascular events: diabetes and peritoneal dialysis (11.95; P<0.001), age >45 (6.77; P<0.001), diabetes (4.87; P<0.001), prior CVE (3.73; P<0.001), creatinine >141 μmol/l (3.16; P=0.001), peritoneal dialysis (3.06; P=0.027), and obesity (0.32; P=0.046); with peripheral-vascular events: diabetes (8.48; P<0.001), tobacco and cytomegalovirus (3.88; P<0.001), age >45 (2.31; P=0.019), and prior CVE (2.25; P=0.016); with mortality: tobacco and deceased-donor (3.52; P<0.001), age >45 (1.81; P=0.002), diabetes (1.76; P=0.002), pulse pressure (1.64; P=0.029), prior CVE (1.52; P=0.04), and dialysis >1 year (1.47; P=0.04). The majority of CVE post-transplant were non-fatal. Previous CVE was strongly associated with CVE post-transplant. Interactions among transplant-specific and traditional risks impacted significantly the incidence of CVE. Modifiable factors such as duration of dialysis, deceased-donor transplantation, and acute rejection should be viewed as cardiovascular risks.

Original languageEnglish (US)
Pages (from-to)757-764
Number of pages8
JournalKidney International
Volume70
Issue number4
DOIs
StatePublished - Aug 28 2006
Externally publishedYes

Keywords

  • Cardiovascular diseases
  • Cytomegalovirus
  • Kidney transplantation
  • Risk factors

ASJC Scopus subject areas

  • Nephrology

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    DeMattos, A. M., Prather, J., Olyaei, A. J., Shibagaki, Y., Keith, D. S., Mori, M., Norman, D. J., & Becker, T. (2006). Cardiovascular events following renal transplantation: Role of traditional and transplant-specific risk factors. Kidney International, 70(4), 757-764. https://doi.org/10.1038/sj.ki.5001628