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Revised Cardiac Risk Index (RCRI) is a useful tool for evaluation of perioperative cardiac morbidity in kidney

Nir Hoftman1, Adrian Prunean, Anahat Dhillon

  • 11 Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA. 2 Transplant Nephrology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA. 3 Cardiology, Department of Medicine, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA. 4 Department of Urology, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA. 5 Address correspondence to: Hans Albin Gritsch, M.D., 10945 Le Conte Avenue, PVUB 3361, Los Angeles, CA 90095-7309.

Transplantation
|July 18, 2013
PubMed

Insights

The Revised Cardiac Risk Index (RCRI) effectively predicts cardiovascular complications in kidney transplant patients. This tool can guide care protocols to minimize risks during and after transplantation.

Area of Science:

  • Nephrology
  • Cardiology
  • Transplant Surgery

Background:

  • Assessing preoperative cardiovascular risk is crucial for kidney transplant recipients.
  • The Revised Cardiac Risk Index (RCRI) is a validated tool for cardiac risk stratification.
  • Its utility in the unique kidney transplant population requires evaluation.

Purpose of the Study:

  • To evaluate the effectiveness of the Revised Cardiac Risk Index (RCRI) in predicting cardiovascular complications in kidney transplant recipients.
  • To determine if RCRI can be utilized as a preoperative cardiovascular risk stratification tool in this patient group.

Main Methods:

  • Retrospective chart review of 1652 kidney transplant recipients (2005-2009).
  • Analysis included 169 recipients with preoperative coronary angiography and 156 age/transplant year-matched controls without angiography.
  • Preoperative cardiovascular risk factors and perioperative cardiac complications were assessed.

Main Results:

  • The number of RCRI risk factors strongly predicted cardiovascular complications (ROC area=0.77, P<0.0001).
  • History of coronary artery disease showed a significant association (OR=20.59, P=0.0001).
  • History of congestive heart failure was also significantly associated (OR=2.95, P=0.0475).

Conclusions:

  • The Revised Cardiac Risk Index (RCRI) is a valuable tool for cardiac risk stratification in kidney transplant recipients.
  • RCRI can inform the development of targeted intraoperative and postoperative care protocols.
  • Utilizing RCRI may help minimize cardiovascular complications in this population.
Abstract

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