title: Low levels of high-density lipoprotein cholesterol: an independent risk factor for late adverse cardiovascular events in renal transplant recipients.
abstract: Long-term kidney transplant graft and patient survival is often limited by cardiovascular (CV) disease. Risk factors for CV disease such as diabetes, hypertension and elevated low-density lipoprotein levels are well documented; however, the impact of low levels of high-density lipoprotein (HDL) has not been defined. We performed a retrospective chart review of 324 consecutive renal transplant recipients from 2001 to 2007 to correlate baseline HDL levels with major adverse cardiovascular events (MACEs) defined as a composite of new onset CV illness, cerebral vascular events and peripheral vascular disease. A total of 92 MACEs occurred over a total of 1913 patient years of follow-up. Low HDL cholesterol levels were noted in 58.3% of patients. Compared with those with normal HDL levels, a greater percentage of patients with low HDL levels had post-transplant MACEs (20% vs. 60% respectively) and experienced an increased rate of all cause mortality. Sixty-two percent of all MACEs occurred in patients with low HDL levels. In the low HDL group, the odds ratio for experiencing a MACE was 1.92. Therefore, HDL cholesterol may provide an important new therapeutic target to prevent vascular morbidity and mortality following renal transplantation.
authors.affiliation: Department of Medicine, State University of New York, University at Buffalo, Buffalo General Hospital, Kaleida Health, Buffalo, NY 14203, USA.
authors.forename: Kulpreet
authors.initials: K
authors.lastname: Barn
authors.forename: Mark
authors.initials: M
authors.lastname: Laftavi
authors.forename: Drew
authors.initials: D
authors.lastname: Pierce
authors.forename: Chin
authors.initials: C
authors.lastname: Ying
authors.forename: William E
authors.initials: WE
authors.lastname: Boden
authors.forename: Oleh
authors.initials: O
authors.lastname: Pankewycz
mesh_terms: D000328:Adult; D050197:Atherosclerosis / Q000209:etiology; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000401:mortality; D008076:Cholesterol, HDL / Q000097:blood*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009518:New York / Q000453:epidemiology; D011183:Postoperative Complications / Q000209:etiology*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL