title: Cerebrovascular events in renal transplant recipients.
abstract: BACKGROUND
  The incidence of stroke and risk factors for different subtypes of cerebrovascular (CBV) events in renal transplant recipients have not been examined in any large prospective controlled trial.
  
  
  METHODS
  The Assessment of Lescol in Renal Transplantation was a randomized, double-blind, placebo-controlled study of the effect of fluvastatin (40-80 mg) daily on cardiovascular, and renal outcomes in renal transplant recipients. Patients initially randomized to fluvastatin or placebo in the 5 to 6 year trial was offered open-label fluvastatin in a 2-year extension to the original study. We investigated the incidence of stroke and risk factors for ischemic and hemorrhagic CBV events in 2102 renal graft recipients participating in the Assessment of Lescol in Renal Transplantation core and extension trial with a mean follow-up of 6.7 years.
  
  
  RESULTS
  The incidence and type of CBV events did not differ between the lipid lowering arm and the placebo arm. A total of 184 (8.8%, 95% confidence interval 4.6-12.9) of 2102 patients experienced a CBV event during follow-up, corresponding to an incidence of 1.3% CBV event per year. The mortality for patients experiencing a hemorrhagic stroke was 48% (13 of 27), whereas the mortality for ischemic strokes was 6.0% (8 of 133). Diabetes mellitus, previous CBV event, age, and serum creatinine were independent risk factors for cerebral ischemic events. The risk of a hemorrhagic cerebral event was increased by diabetes mellitus, polycystic kidney disease, left ventricular hypertrophy, and systolic blood pressure.
  
  
  CONCLUSIONS
  Risk factors for CBV events in renal transplant recipients differ according to subtype.
authors.affiliation: Department of Medicine, Renal Section, National Hospital, Oslo, Norway. sadollah.abedini@gmail.com
authors.forename: Sadollah
authors.initials: S
authors.lastname: Abedini
authors.forename: Ingar
authors.initials: I
authors.lastname: Holme
authors.forename: Bengt
authors.initials: B
authors.lastname: Fellström
authors.forename: Alan
authors.initials: A
authors.lastname: Jardine
authors.forename: Edward
authors.initials: E
authors.lastname: Cole
authors.forename: Bart
authors.initials: B
authors.lastname: Maes
authors.forename: Hallvard
authors.initials: H
authors.lastname: Holdaas
mesh_terms: D002561:Cerebrovascular Disorders / Q000473:pathology / Q000517:prevention & control; D005229:Fatty Acids, Monounsaturated / Q000494:pharmacology; D000077340:Fluvastatin; D006801:Humans; D007211:Indoles / Q000494:pharmacology; D016030:Kidney Transplantation; D012307:Risk Factors
chemical_list: D005229:Fatty Acids, Monounsaturated; D007211:Indoles; D000077340:Fluvastatin