Coronary event rates in liver transplant recipients reflect the increased prevalence of cardiovascular risk-factors.
Increased prevalence of cardiovascular risk-factors in liver transplant recipients compared with pretransplant and standard population data has been acknowledged. The impact of risk-profiles on cardiovascular event rates or death, however, has not yet been established. Here we evaluate the development of risk-factors during a prospective follow-up of 10 years in 302 patients and compare numbers of coronary events with data from the German Prospective Cardiovascular Münster (PROCAM)-Score population. Prevalence of overweight (17% vs. 27%), hypertension (70% vs. 80%), and diabetes (21% vs. 25%) increased from early to late after transplantation, while elevated serum cholesterol (64% vs. 37%) and triglycerides (40% vs. 21%) became less frequent. Cardiovascular risk-profiles favoring tacrolimus over ciclosporin A based immunosuppression early after transplantation converged over time. Increased risk-scores in liver transplant recipients matched with score standardized event rates in the PROCAM population (ratio: 1.11, 95% CI: 0.53-2.03), nine events were predicted for the transplant population and oppose 10 events observed. Thus, indicating a reflection of increased cardiovascular risk-profiles in corresponding numbers of cardiovascular events.
Guckelberger
Olaf
O
Department of General, Visceral and Transplantation Surgery, Charité- Campus Virchow-Klinikum, Berlin, Germany. olaf.guckelberger@charite.de
Byram
Alice
A
Klupp
Jochen
J
Neumann
Ulf P
UP
Glanemann
Matthias
M
Stockmann
Martin
M
Neuhaus
Ruth
R
Neuhaus
Peter
P
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology*; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors