title: Cardiovascular disease medications after renal transplantation: results from the Patient Outcomes in Renal Transplantation study.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the most common cause of death after kidney transplantation. Nevertheless, the use of potentially protective CVD medications has not been examined in a large international cohort of kidney transplant patients.
  
  
  METHODS
  Using the Patient Outcomes in Renal Transplantation database, we retrospectively examined CVD medication use in 14,236 kidney transplant patients from 10 centers worldwide at 4 and 12 months posttransplant.
  
  
  RESULTS
  Use of CVD medications posttransplant increased between 1990 to 1994 and 2000 to 2006, with a 12-fold increase in the use of statins (odds ratio [OR] 12.28, 95% confidence interval [CI] 10.18-14.80). Use of β-blockers also increased (OR 3.74, 95% CI 3.20-4.38), as did use of angiotensin converting enzyme inhibitors or angiotensin II receptor blockers (OR 3.68, 95% CI 3.07-4.40) and antiplatelet agents (OR 1.93, 95% CI 1.66-2.24). Use of most CVD medications was not higher in patients with diabetes than in patients without diabetes, despite a higher risk of CVD among patients with diabetes. Although use of several CVD medications was higher in patients with previous CVD events than in patients with no previous CVD, less than 75% of patients with previous CVD were using a statin or antiplatelet agent.
  
  
  CONCLUSIONS
  Although use of CVD medications after kidney transplant has increased in recent years, use of potentially cardioprotective medications may be suboptimal given the high CVD risk in kidney transplant patients.
authors.affiliation: Department of Renal Medicine, Auckland City Hospital, 2 Park Road, Grafton, Auckland, New Zealand. hpilmore@adhb.govt.nz
authors.forename: Helen L
authors.initials: HL
authors.lastname: Pilmore
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Skeans
authors.forename: Jon J
authors.initials: JJ
authors.lastname: Snyder
authors.forename: Ajay K
authors.initials: AK
authors.lastname: Israni
authors.forename: Bertram L
authors.initials: BL
authors.lastname: Kasiske
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000517:prevention & control*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007391:International Cooperation; D016030:Kidney Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D010975:Platelet Aggregation Inhibitors