Acute myocardial infarction after renal transplantation

The authors evaluated the incidence of acute myocardial infarction (AMI) in a group of 355 renal graft recipients operated on at the Institute for Clinical and Experimental Medicine between 1976 and 1984. AMI was diagnosed in 12 (3%), mostly male, patients. The age of AMI survivors was higher on the average (47.5 years) than that of other renal graft recipients whose mean age was 37 years. Another difference was a higher proportion of patients aged 50 and more. Compared with a selected control group of transplant recipients (n = 97) of corresponding age and follow-up period, the incidence of AMI rose to 9%. The prognosis of renal graft recipients with AMI was a favourable one, only in two cases was AMI and its complications the immediate cause of death. Cumulative doses of immunosuppressive drugs (prednisone, azathioprine, and methylprednisolone) were higher in AMI patients. The difference was not statistically significant in view of the low number of patients. The observed differences should be taken into account when designing corticosteroid dosing schedules in elderly graft recipients.