Predictors of cardiovascular events and associated mortality of kidney transplant recipients.
BACKGROUND
Cardiovascular disease is the most common cause of death after renal transplantation. Furthermore, acute coronary syndrome (ACS) attributable to coronary artery disease (CAD) accounts for the majority of deaths due to cardiovascular disease posttransplant. Although renal transplantation is the treatment of choice for end-stage renal disease, understanding the causes of graft and patient loss is exceedingly important to improve outcomes.


METHODS
This observational study included 1200 patients who underwent a kidney transplant between 1988 and 2003. The outcome was the occurrence of an ACS event within a maximum of 15 years after renal transplantation.


RESULTS
Of all 215 deaths, 28.3% were caused by complications of CAD, the most common cause of death at our center. On multivariate analysis, diabetes (P = .005), prior transplant (P = .047), body mass index (BMI) at the time of transplant (P = .01), cholesterol level (P = .012), and low-density lipoprotein (LDL) level (P = .007) during 3 years after transplant were associated with early ACS. In conclusion, diabetes, prior transplant, BMI, cholesterol, and LDL were significantly associated with early ACS highlighting the importance of improved screening and perioperative management.
Fazelzadeh
A
A
Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. fazelzadeh23@yahoo.com
Mehdizadeh
A R
AR
Ostovan
M A
MA
Raiss-Jalali
G A
GA
D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D002784:Cholesterol / Q000097:blood; D003920:Diabetes Mellitus / Q000401:mortality; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008077:Lipoproteins, LDL / Q000097:blood; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016019:Survival Analysis; D016896:Treatment Outcome
D008077:Lipoproteins, LDL; D002784:Cholesterol