title: Prevalence and predictors of early cardiovascular events after kidney transplantation: evaluation of pre-transplant cardiovascular work-up.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of mortality after renal transplantation. The purpose of this study was to analyze cardiovascular risk factors at transplantation, occurrence of cardiovascular events in the first year after transplantation and evaluate pre-transplant work-up.
  
  
  METHODS
  In total, 244 renal transplant recipients older than 50 years were included. The results of pre-transplant work-up, including clinical evaluation, electrocardiogram, echocardiography, myocardial perfusion testing and coronary angiography were analyzed.
  
  
  RESULTS
  Patients had multiple risk factors at inclusion on renal transplantation waiting list as high blood pressure (94.7%), dyslipidemia (81.1%), smoking (45.3%), diabetes (23.6%), past history of cardiovascular disease (21.3%) and obesity (12.7%). Following transplantation, 15.5% (n = 38) of patients experienced a cardiovascular event, including 2.8% (n = 7) acute coronary syndrome, 5.8% (n = 14) isolated increase in troponin level and 5.3% (n = 13) new onset atrial fibrillation. The pre-transplant parameters associated with a cardiovascular event were a past medical history of cardiovascular disease (HR = 2.06 [1.06-4.03], p = 0.03), echocardiographic left ventricular hypertrophy (HR = 2.04 [1.04-3.98], p = 0.037) and abnormal myocardial perfusion testing (HR = 2.25 [1.09 -5.96], p = 0.03). Pre-transplantation evaluation allowed the diagnosis of unknown coronary artery lesions in 8.9% of patients.
authors.affiliation: Department of Nephrology and Transplantation, Hôpital Necker Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Marianne
authors.initials: M
authors.lastname: Delville
authors.affiliation: Department of Cardiology, Hôpital Necker, APHP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Sabbah
authors.affiliation: Department of Biostatistics, Hôpital Necker, APHP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Girard
authors.affiliation: Department of Biostatistics, Hôpital Necker, APHP, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Caroline
authors.initials: C
authors.lastname: Elie
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France; Department of Clinical Research, Hôpital Necker, APHP, Paris, France.
authors.forename: Sandra
authors.initials: S
authors.lastname: Manceau
authors.affiliation: Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France; Department of Functional Explorations, Hôpital Necker, APHP, Paris, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Piketty
authors.affiliation: Department of Nephrology and Transplantation, Hôpital Necker Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Frank
authors.initials: F
authors.lastname: Martinez
authors.affiliation: Department of Nephrology and Transplantation, Hôpital Necker Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Arnaud
authors.initials: A
authors.lastname: Méjean
authors.affiliation: Department of Nephrology and Transplantation, Hôpital Necker Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Legendre
authors.affiliation: Department of Nephrology and Transplantation, Hôpital Necker Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, RTRS « Centaure », Labex « Transplantex », Paris, France.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Sberro-Soussan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D002319:Cardiovascular System; D017023:Coronary Angiography / Q000379:methods; D016208:Databases, Factual; D048909:Diabetes Complications; D050171:Dyslipidemias / Q000150:complications; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007676:Kidney Failure, Chronic / Q000150:complications / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications; D010477:Perfusion; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D011184:Postoperative Period; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking