title: A Comparison of Different Algorithms for the Assessment of Cardiovascular Risk in Patients at Waiting List for Kidney Transplantation.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the leading cause of death after renal transplantation with a high prevalence in dialysis patients. It is still a matter of debate how to assess the cardiovascular risk in kidney transplant candidates. Several approaches and scores exist and found their way into the guidelines.
  
  
  RESULTS
  We herein assessed PROCAM, Framingham, ESC-SCORE and our own dedicated algorithm in patients applying for renal transplantation at our transplantation center between July 2006 and August 2009. Data of 347 consecutive patients were recorded at baseline and during a follow-up of 4.1 years regarding cardiovascular (CV) events and event-free and overall survival. During follow-up 31 (8.9%) patients died, 24 (6.9%) myocardial infarctions occurred and 19 (5.5%) patients received a new diagnosis of cerebrovascular disease. Predictors for event-free survival identified by univariable Cox regression analysis were age at start of dialysis, ESC-SCORE as well as our own score. Final multivariable model with a stepwise model building procedure revealed age at start of dialysis and smoking to be prognostic for event-free (hazard ratio 1.07/year and 2.15) and overall survival (1.10/year and 3.72).
  
  
  CONCLUSIONS
  Comparison of CV risk assessment scores showed that ESC-SCORE most robustly predicted event-free and overall survival in our cohort. We conclude that CV risk assessment by ESC-SCORE can be reasonably performed in kidney transplant candidates.
authors: Department of Internal Medicine D, University Hospital Münster, Münster, Germany.
authors: Stefan
authors: S
authors: Reuter
authors: Department of Internal Medicine D, University Hospital Münster, Münster, Germany.
authors: Stefanie
authors: S
authors: Reiermann
authors: Department of Internal Medicine D, University Hospital Münster, Münster, Germany.
authors: Viola
authors: V
authors: Malyar
authors: Department of Internal Medicine D, University Hospital Münster, Münster, Germany.
authors: Katharina
authors: K
authors: Schütte-Nütgen
authors: Institute of Biostatistics and Clinical Research, University Hospital Münster, Münster, Germany.
authors: Renè
authors: R
authors: Schmidt
authors: Department of Internal Medicine D, University Hospital Münster, Münster, Germany.
authors: Hermann
authors: H
authors: Pavenstädt
authors: Division of Vascular Medicine, Department of Cardiovascular Medicine, University Hospital Münster, Münster, Germany.
authors: Holger
authors: H
authors: Reinecke
authors: Department of Internal Medicine D, University Hospital Münster, Münster, Germany.
authors: Barbara
authors: B
authors: Suwelack
mesh_terms: D000328:Adult; D000465:Algorithms; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012189:Retrospective Studies; D018570:Risk Assessment; D014850:Waiting Lists