title: Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis.
abstract: The high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients.
  
  
  
  An observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981-2011 was completed. Competing risk survival analysis methods were applied to estimate the cumulative incidence of developing cardiovascular events over time and to identify which characteristics were associated with the risk of these events. Post-transplant cardiovascular events are defined as the presence of myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances, peripheral vascular disease and cardiovascular disease and death. The cause of death was identified through the medical history and death certificate using ICD9 (390-459, except: 427.5, 435, 446, 459.0).
  
  
  
  The mean age of patients at the time of transplantation was 47.0 ± 14.2 years; 62% were male. 16.5% had suffered some cardiovascular disease prior to transplantation and 9.7% had suffered a cardiovascular event. The mean follow-up period for the patients with cardiovascular event was 3.5 ± 4.3 years. Applying competing risk methodology, it was observed that the accumulated incidence of the event was 5.0% one year after transplantation, 8.1% after five years, and 11.9% after ten years. After applying multivariate models, the variables with an independent effect for predicting cardiovascular events are: male sex, age of recipient, previous cardiovascular disorders, pre-transplant smoking and post-transplant diabetes.
  
  
  
  This study makes it possible to determine in kidney transplant patients, taking into account competitive events, the incidence of post-transplant cardiovascular events and the risk factors of these events. Modifiable risk factors are identified, owing to which, changes in said factors would have a bearing of the incidence of events.
authors.affiliation: Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, Hotel de Pacientes 7ª Planta, C/As Xubias de Arriba, 84, 15006, A Coruña, Spain.
authors.forename: María Teresa
authors.initials: MT
authors.lastname: Seoane-Pillado
authors.affiliation: Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, Hotel de Pacientes 7ª Planta, C/As Xubias de Arriba, 84, 15006, A Coruña, Spain. salvador.pita.fernandez@sergas.es.
authors.forename: Salvador
authors.initials: S
authors.lastname: Pita-Fernández
authors.affiliation: Department of Nephrology, A Coruña Hospital, As Xubias 84, A Coruña, 15006, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Valdés-Cañedo
authors.affiliation: Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, Hotel de Pacientes 7ª Planta, C/As Xubias de Arriba, 84, 15006, A Coruña, Spain.
authors.forename: Rocio
authors.initials: R
authors.lastname: Seijo-Bestilleiro
authors.affiliation: Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, Hotel de Pacientes 7ª Planta, C/As Xubias de Arriba, 84, 15006, A Coruña, Spain.
authors.forename: Sonia
authors.initials: S
authors.lastname: Pértega-Díaz
authors.affiliation: Department of Nephrology, A Coruña Hospital, As Xubias 84, A Coruña, 15006, Spain.
authors.forename: Constantino
authors.initials: C
authors.lastname: Fernández-Rivera
authors.affiliation: Department of Nephrology, A Coruña Hospital, As Xubias 84, A Coruña, 15006, Spain.
authors.forename: Ángel
authors.initials: Á
authors.lastname: Alonso-Hernández
authors.affiliation: Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, Hotel de Pacientes 7ª Planta, C/As Xubias de Arriba, 84, 15006, A Coruña, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: González-Martín
authors.affiliation: Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, Hotel de Pacientes 7ª Planta, C/As Xubias de Arriba, 84, 15006, A Coruña, Spain.
authors.forename: Vanesa
authors.initials: V
authors.lastname: Balboa-Barreiro
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiovascular diseases; Kidney transplantation; Risk factors; Survival analysis