Assessment of cardiovascular risk in waiting-listed renal transplant patients: a single center experience in 558 cases.
Cardiac screening is recommended to prevent cardiovascular death after renal transplantation. This retrospective observational study illustrates the results of application of a cardiac assessment algorithm in a series of 558 renal transplant candidates at a single center in Turin, Italy. A dipyridamole-stress sestamibi myocardial scintiscan (DMS) performed in 302/558 (54.1%) cases was positive in 52 (17.2%), negative in 200 (66.2%), borderline in 16 (5.3%), and with signs of previous necrosis in 34 (11.4%). Coronary lesions detected by angiography in 48.1% of the 52 positives were treated medically (13.5%) or by percutaneous/surgical procedure (34.6%). Coronary lesions were detected in 14.1% of asymptomatic population subgroup. The minor and major cardiovascular event rates and the cardiovascular death rate were 1.9%, 0%, and 0%, respectively, in positive DMS group (high-cardiological risk) vs. 10%, 4.5%, and 3.5% in the negatives (p > 0.5; n.s.). It is suggested that not increased cardiovascular event or deaths rates in the high-risk group reflect early coronary lesion detection and correction. Since 55.9% of cardiovascular events or deaths occurred in the negative group more than 24 months after the DMS, its mandatory repetition every two yr after a negative finding is recommended.
Leonardi
G
G
Renal Transplantation Unit, Nephrology, Dialysis and Transplantation Division, S. Giovanni Battista Hospital, Turin, Italy. leonardigl@hotmail.com
Tamagnone
M
M
Ferro
M
M
Tognarelli
G
G
Messina
M
M
Giraudi
R
R
Fop
F
F
Picciotto
G
G
Biancone
L
L
Segoloni
G P
GP
D000328:Adult; D000368:Aged; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D004176:Dipyridamole; D005080:Exercise Test; D005260:Female; D006801:Humans; D007558:Italy; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D016896:Treatment Outcome; D014850:Waiting Lists
D004176:Dipyridamole