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Metabolic profile and cardiovascular risk in a population of renal transplant recipients
M Gonçalves1, P Vieira1, L Resende1
1Department of Nephrology, Hospital Central do Funchal, Funchal, Portugal.
Insights
Renal transplant recipients have many cardiovascular risks, increasing their chances of major adverse cardiac events and death. Early risk prediction is key to improving outcomes and survival for these patients.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Medicine
Background:
- Cardiovascular disease (CVD) is highly prevalent in renal transplant recipients (RTRs).
- CVD is a leading cause of graft loss and mortality in RTRs.
- Understanding CVD risk factors in RTRs is critical for improving patient and graft survival.
Purpose of the Study:
- To characterize cardiovascular risk factors in RTRs.
- To calculate 7-year risks for major adverse cardiac events (MACE) and death.
- To identify key risk factors associated with MACE and mortality prediction in RTRs.
Main Methods:
- Retrospective review of clinical data from 121 RTRs.
- Patients had stable, functioning grafts for over 6 months.
- Utilized a cardiovascular risk calculator for 7-year risk prediction.
Main Results:
- High prevalence of risk factors: 86.8% hypertension, 19.8% diabetes, 24.8% smokers, 61.9% increased BMI, 71% dyslipidemia.
- 31.4% of patients had >10% 7-year risk for MACE (age, diabetes, smoking were predictors).
- 46.3% of patients had >10% 7-year risk for death (age, diabetes, BP, smoking, male gender were predictors).
Conclusions:
- RTRs exhibit a high burden of cardiovascular risk factors.
- There is a significantly elevated 7-year risk for MACE and death in this population.
- Accurate cardiovascular risk prediction is essential for clinical decision-making, patient education, and enhancing long-term survival in RTRs.
Introduction:
Cardiovascular disease is more common in renal transplant recipients (RTRs) than in the general population, and is the major cause of both graft loss and patient death in RTRs.
Objectives:
This study aimed to characterize the cardiovascular risk factors, calculate the 7-year risk for major adverse cardiac events and the 7-year risk for death in a population of RTRs using a cardiovascular risk calculator, and determine the main cardiovascular risk factors associated with increased prediction of major adverse cardiac event (MACE) and death.
Patients:
This is a retrospective review of clinical data from 121 RTRs who are in follow-up programs at our institution, and who had a functioning and stable graft for longer than 6 months.
Results:
Among 121 adult patients followed at our institution (59.5% males, mean age of 49.6 ± 13.8 years, mean times for functioning grafts were 105 ± 73.5 mo), 86.8% had hypertension, 19.8% had diabetes, 24.8% were current or former smokers, 61.9% had increased body mass index, and 71% had dyslipidemia. The 7-year risk for MACE was more than 10% in 38 (31.4%) patients with age, diabetes, and smoke being independent risk predictors. The 7-year risk for death was more than 10% in 56 (46.3%) patients with age, diabetes, blood pressure, smoking, and male gender being independent risk predictors.
Conclusion:
There is a high prevalence of cardiovascular risk factors in a population of RTRs, and there is increased risk for MACE and death. Accurate risk prediction is important for physician decision support and patient education, promoting improved cardiovascular health of RTRs, and thus prolonging the survival of both patients and graft.
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