title: Cardiovascular disease: Risk factors and applicability of a risk model in a Greek cohort of renal transplant recipients.
abstract: OBJECTIVE
  To investigate the incidence and the determinants of cardiovascular morbidity in Greek renal transplant recipients (RTRs) expressed as major advance cardiac event (MACE) rate.
  
  
  METHODS
  Two hundred and forty-two adult patients with a functioning graft for at least three months and available data that were followed up on the August 31, 2015 at two transplant centers of Western Greece were included in this study. Baseline recipients' data elements included demographics, clinical characteristics, history of comorbid conditions and laboratory parameters. Follow-up data regarding MACE occurrence were collected retrospectively from the patients' records and MACE risk score was calculated for each patient.
  
  
  RESULTS
  The mean age was 53 years (63.6% males) and 47 patients (19.4%) had a pre-existing cardiovascular disease (CVD) before transplantation. The mean estimated glomerular filtration rate was 52 ± 17 mL/min per 1.73 m2. During follow-up 36 patients (14.9%) suffered a MACE with a median time to MACE 5 years (interquartile range: 2.2-10 years). Recipients with a MACE compared to recipients without a MACE had a significantly higher mean age (59 yearsvs52 years,P< 0.001) and a higher prevalence of pre-existing CVD (44.4%vs15%,P< 0.001). The 7-year predicted mean risk for MACE was 14.6% ± 12.5% overall. In RTRs who experienced a MACE, the predicted risk was 22.3% ± 17.1% and was significantly higher than in RTRs without an event 13.3% ± 11.1% (P= 0.003). The discrimination ability of the model in the Greek database of RTRs was good with an area under the receiver operating characteristics curve of 0.68 (95%CI: 0.58-0.78).
  
  
  CONCLUSIONS
  In this Greek cohort of RTRs, MACE occurred in 14.9% of the patients, pre-existing CVD was the main risk factor, while MACE risk model was proved a dependable utility in predicting CVD post RT.
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Nikolaos-Andreas
authors.initials: NA
authors.lastname: Anastasopoulos
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Evangelia
authors.initials: E
authors.lastname: Dounousi
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Evangelos
authors.initials: E
authors.lastname: Papachristou
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Charalampos
authors.initials: C
authors.lastname: Pappas
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Eleni
authors.initials: E
authors.lastname: Leontaridou
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Eirini
authors.initials: E
authors.lastname: Savvidaki
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Goumenos
authors.affiliation: Nikolaos-Andreas Anastasopoulos, Evangelia Dounousi, Michael Mitsis, Department of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece.
authors.forename: Michael
authors.initials: M
authors.lastname: Mitsis
keywords: Cardiovascular disease; Kidney; Major advance cardiac event; Risk factors; Risk model; Transplantation