Factors in cardiac risk stratification of candidates for renal transplant.
BACKGROUND
Renal transplant candidates are at high risk of fatal and nonfatal cardiac events.


METHODS
This study evaluated five clinical risk factors--age at least 50 years, insulin-requiring diabetes mellitus, angina, congestive heart failure and an abnormal electrocardiogram (ECG) (excluding left ventricular hypertrophy)--that had been used in the first tier of a two-tiered prospectively applied risk stratification algorithm.


RESULTS
Using multiple logistic regression analysis, age at least 50 years, abnormal ECG, and diabetes mellitus were independently predictive of cardiac death. Of the two remaining clinical risk factors, the presence of angina had independent predictive value for nonfatal cardiac events (myocardial infarction, coronary angioplasty, bypass surgery, and unstable angina). The independent predictive value of congestive heart failure approached statistical significance.


CONCLUSIONS
Clinical risk-factor analysis is helpful in identifying renal transplant candidates at high risk for fatal or nonfatal cardiac events.
Lewis
M S
MS
Division of Cardiology, Department of Medicine, Oregon Health Sciences University, Portland 97201, USA.
Wilson
R A
RA
Walker
K
K
Stegeman-Olsen
J
J
Norman
D J
DJ
Barry
J M
JM
Bennett
W M
WM
D000465:Algorithms; D017023:Coronary Angiography; D003643:Death; D004562:Electrocardiography; D005080:Exercise Test; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis* / Q000401:mortality; D006801:Humans; D016030:Kidney Transplantation / Q000401:mortality; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015635:Radionuclide Ventriculography / Q000379:methods; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes