Incidence of coronary heart disease and cardiac events in patients undergoing kidney and pancreatic transplantation.
One major cause of graft loss after kidney transplantation or simultaneous kidney and pancreas transplantation is death of the recipient due to cardiac events. Records of 261 patients who underwent sole kidney (group A) or combined kidney-pancreas transplantation (group B) were retrospectively analyzed. Patients were divided into groups with basic cardiac evaluation (chest X-ray, electrocardiogram) and patients with additional diagnostics [echocardiography, exercise stress test, myocardial perfusion test, and coronary angiography (CAG)]. The results of the performed CAGs were as follows: proven coronary artery disease (CAD) in 22 patients (12.43%) in group A and 37 patients (44.05%) in group B; stenosis of one main coronary artery of 70% or greater in 8.47% (group A) and 16.67% (group B) of the patients. Subsequent revascularization procedures were performed in 15 candidates (8.47%) of group A and 11 (13.10%) of group B. The incidence of posttransplant cardiac events (PCE) was lower in recipients in both groups who underwent additional cardiac evaluation. Late postoperative deaths were reported in 3.45% of kidney recipients with no additional evaluation (group A), in 2.06% of patients with further diagnostics (group A), and in only 1.19% of patients with invasive pretransplant evaluation (group B). Patients with known CAD and no further invasive diagnostics or subsequent revascularization are at great risk. PCE were observed in three of seven patients in this subgroup. Careful cardiac evaluation including echocardiography, exercise stress test, myocardial perfusion test, and CAG is associated with a low incidence of PCE.
Eschertzhuber
S
S
Department of Anaesthesiology and Critical Care Medicine, Innsbruck Medical University, Innsbruck, Austria. stephan.eschertzhuber.uibk.ac.at
Hohlrieder
M
M
Boesmueller
C
C
Pomaroli
A
A
Steurer
W
W
Junker
T
T
Margreiter
R
R
Hoermann
C
C
D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000453:epidemiology*; D004562:Electrocardiography; D006331:Heart Diseases / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016030:Kidney Transplantation / Q000401:mortality; D009203:Myocardial Infarction / Q000401:mortality; D016035:Pancreas Transplantation / Q000401:mortality; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis