Incidence of Post-Transplantation Major Adverse Cardiovascular Events in Lung Transplant Recipients With No Prior...

Cardiovascular disease (CVD) is a significant concern after solid organ transplantation, partly due to the adverse effects of immunosuppressive therapy. However, the incidence of major adverse cardiovascular events (MACE) in patients without prior CVD among this population is not well understood. This study aimed to evaluate the occurrence of MACE in lung transplant recipients (LTRs) without pre-existing CVD.

We reviewed retrospectively LTRs without known CVD between 2003 and 2019. MACE outcomes included acute coronary syndrome, revascularization, cerebrovascular events, peripheral vascular disease, and cardiovascular mortality.

Of 342 LTRs (median 55.0 (41.0, 61.0); 42.2% female), 16 (4.7%) developed MACE over a median follow-up of 54.5 months. Logistic regression analysis demonstrated a significant association between developing two or more post-transplant risk factors for CVD, such as HTN and DM, and an increased likelihood of MACE (OR 5.672, CI 1.092-29.464, P = .039). There was a trend toward higher mortality in the MACE group, 62.5%, compared to 39.0% in the control group (P = .0707). COX regression analysis showed that single lung transplantation was significantly associated with poorer survival (HR 1.762, 95% CI 1.135-2.73, P = .0116). Older age and CKD showed a trend toward higher mortality (HR 1.013, P = .1681; HR 1.369, P = .092, respectively).

MACE incidence was low in this large cohort of LTRs without pre-transplant CVD. Developing two or more post-transplant CVD risk factors was associated with an increased risk for MACE, highlighting the importance of rigorous post-transplant management to mitigate MACE risk.