Screening Transplant Waitlist Candidates for Coronary Artery Disease

Gill, John S.

doi:10.2215/cjn.10510918

Cited by 4 publications

(2 citation statements)

References 9 publications

(5 reference statements)

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“…Our study analyzed the effectiveness of our pretransplant risk-stratified protocol using screening coronary angiography in detecting significant cardiovascular disease in patients undergoing renal transplants and the impact of this approach on the incidence of posttransplant cardiac events. We believed that CAG is the most effective approach for CAD detection because in ESRD patients, the sensitivity and specificity of stress tests used for the detection of significant CAD are insufficient despite the high negative predictive value ( 15 , 24 , 25 ).…”

Section: Discussionmentioning

confidence: 99%

Standardized risk-stratified cardiac assessment and early posttransplant cardiovascular complications in kidney transplant recipients

Rajnochova Bloudickova,

Janek,

Machackova

et al. 2024

Front. Cardiovasc. Med.

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IntroductionCardiovascular disease (CVD) is the leading cause of morbidity and mortality in kidney transplant recipient (KTR). There is a dearth of standardized guidelines on optimal cardiovascular evaluation of transplant candidates.MethodsThis single-center cohort study aims to determine the effectiveness of our standardized risk-stratified pretransplant cardiovascular screening protocol, which includes coronary angiography (CAG), in identifying advanced CVD, the proper pretransplant management of which could lead to a reduction in the incidence of major cardiac events (MACE) in the early posttransplant period.ResultsOut of the total 776 KTR transplanted between 2017 and 2019, CAG was performed on 541 patients (69.7%), of whom 22.4% were found to have obstructive coronary artery disease (CAD). Asymptomatic obstructive CAD was observed in 70.2% of cases. In 73.6% of cases, CAG findings resulted in myocardial revascularization. MACE occurred in 5.6% (N = 44) of the 23 KTR with pretransplant CVD and 21 without pretransplant CVD. KTR with posttransplant MACE occurrence had significantly worse kidney graft function at the first year posttransplant (p = 0.00048) and worse patient survival rates (p = 0.0063) during the 3-year follow-up period compared with KTR without MACE. After adjustment, the independent significant factors for MACE were arrhythmia (HR 2.511, p = 0.02, 95% CI 1.158–5.444), pretransplant history of acute myocardial infarction (HR 0.201, p = 0.046, 95% CI 0.042–0.970), and pretransplant myocardial revascularization (HR 0.225, p = 0.045, 95% CI 0.052–0.939).ConclusionAsymptomatic CVD is largely prevalent in KTR. Posttransplant MACE has a negative effect on grafts and patient outcomes. Further research is needed to assess the benefits of pretransplant myocardial revascularization in asymptomatic kidney transplant candidates.

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Section: Discussionmentioning

confidence: 99%

Standardized risk-stratified cardiac assessment and early posttransplant cardiovascular complications in kidney transplant recipients

Rajnochova Bloudickova,

Janek,

Machackova

et al. 2024

Front. Cardiovasc. Med.

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“…The classic risk factors for CAD include diabetes, hypertension, prior cardiovascular disease, dialysis vintage >1 y, dyslipidemia, age >60 y, left ventricular hypertrophy, and smoking. 7,[12][13][14] Kidney transplant patients are put on immunosuppressive medications posttransplant that increases the risk of hypertension, diabetes, and dyslipidemia. 7,13 We found that among all the deceased donor kidney transplants done in the US, more than half (58%) received kidneys from donors in the KDPI 35% to 85% category.…”

Section: Discussionmentioning

confidence: 99%

Is Exclusion of Coronary Artery Disease in the Kidney Allocation System Preventing Optimal Longevity Matching?

Tandukar

2023

Transplantation

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The author declares no funding or conflict of interest. S.T. conceived the idea of the project, designed the research plan, performed the data analysis, and wrote the article.The data reported here have been supplied by the USRDS. The interpretation and reporting of these data are the responsibility of the author(s) and in no way should be seen as an official policy or interpretation of the US Government.

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Cardiac Risk Assessment

Pankewycz,

Laftavi

2023

Transplantation of the Pancreas

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Screening Transplant Waitlist Candidates for Coronary Artery Disease

Cited by 4 publications

References 9 publications

Standardized risk-stratified cardiac assessment and early posttransplant cardiovascular complications in kidney transplant recipients

Standardized risk-stratified cardiac assessment and early posttransplant cardiovascular complications in kidney transplant recipients

Is Exclusion of Coronary Artery Disease in the Kidney Allocation System Preventing Optimal Longevity Matching?

Cardiac Risk Assessment

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