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Clinical outcome of renal transplant patients after coronary stenting
Fábio Monteiro Mota1, Juliana Araújo, José Airton Arruda
1Hospital do Rim e Hipertensão, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, SP, Brazil. fby98@ig.com.br
Insights
Renal transplant patients treated with coronary stenting (TCA-ST) for coronary artery disease (CAD) experienced a low restenosis rate. This outcome may be linked to immunosuppressive therapy used in kidney transplant recipients.
Area of Science:
- Cardiology
- Nephrology
- Transplantation Medicine
Background:
- Coronary artery disease (CAD) is a significant concern in renal transplant recipients.
- Assessing the efficacy of percutaneous coronary intervention in this vulnerable population is crucial.
Purpose of the Study:
- To evaluate the clinical outcomes of renal transplant patients treated with coronary stenting (TCA-ST) for established CAD.
Main Methods:
- Retrospective analysis of 33 renal transplant patients who underwent TCA-ST for 62 severe coronary stenoses.
- Clinical events were tracked over a 30-month follow-up period using medical records and patient contact.
Main Results:
- 67% of patients remained asymptomatic post-TCA-ST, with 18% experiencing stable angina.
- No strokes, congestive heart failure (CHF), or cardiac deaths were reported.
- A 9% restenosis rate was observed, comparable to drug-eluting stent outcomes.
Conclusions:
- Coronary stenting in renal transplant recipients with CAD demonstrates favorable short-term clinical outcomes.
- The low restenosis rate may be influenced by the immunosuppressive regimens used to prevent kidney transplant rejection.
Objective:
To assess the clinical outcome of renal transplant patients who developed coronary artery disease and were treated with coronary stenting (TCA-ST).
Methods:
A total of 3,334 renal transplants were performed in our service--Hospital do Rim e Hipertensão--HRH (Kidney and Hypertension Hospital) from July, 1998 to November, 2004. During this period, 33 of the renal transplant patients underwent TCA-ST to treat 62 severe stenoses in 54 coronary arteries. A retrospective analysis was performed with renal transplant patients undergoing TCA-ST at HRH. The clinical events were registered using medical charts, medical visits and phone calls.
Results:
During the 30-month clinical follow-up after TCA-ST, 67% of the patients remained asymptomatic, 18% presented stable angina, 6% presented acute coronary syndrome without ST-segment elevation (ACSWSTE), and 3% presented acute coronary syndrome with ST-segment elevation (ACSSTE). No strokes, CHF or cardiac deaths were observed. Three non-cardiac deaths occurred. A restenosis rate of 9% was observed, which is comparable to those found in studies on drug-eluting stents.
Conclusion:
In conclusion, renal transplant patients who developed CAD and were treated with coronary stenting had a low rate of in-stent restenosis, probably related to the immunosuppressive regimen given to prevent kidney rejection.
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