Cardiac evaluation for end-stage kidney disease patients on the transplant waitlist: a single-center cohort study.

Content Provider	Europe PMC
Author	Vijayan, Swati Ho, Quan Yao Koh, Choong Hou Liew, Ian Tatt Thangaraju, Sobhana Wong, Ningyan Keh, Yann Shan Ong, Zi Hui Sharel Tan, Jia Qin Yeo, Khung Keong Chua, Terrance Siang Jin Kee, Terence
Copyright Year	2022
Abstract	BackgroundCardiac evaluation before deceased donor kidney transplant (DDKT) remains a matter of debate. Data on Asian countries and countries with prolonged waiting times are lacking. This study aimed to assess the outcomes of patients referred for DDKT after a cardiac evaluation at an Asian tertiary transplant center.MethodsThis single-center retrospective review analyzed patients who were referred for waitlist placement and underwent cardiac stress testing between January 2009 and December 2015. Patients with cardiac symptoms were excluded. The primary outcome was three-point major adverse cardiovascular events (MACE), a composite of non-fatal myocardial infarction, non-fatal stroke, and cardiovascular death.ResultsOf 468 patients referred for DDKT, 198 who underwent cardiac stress testing (myocardial perfusion studies in 159 patients and stress echocardiography in 39 patients) were analyzed. MACE occurred in 20.7% of the patients over a median follow-up of 4.6 years. Cardiac stress tests were positive for ischemia in 19.7% of the patients. Coronary angiography was performed in 63 patients, including 29 patients with diabetic kidney disease and negative cardiac stress tests. Significant coronary artery disease (CAD) was detected in 27 patients (42.8%), of whom 18 underwent revascularization. MACE was associated with significant CAD on coronary angiography in the multivariable analysis. Cardiac stress test results were not associated with MACE. Amongst diabetic patients who had negative cardiac stress tests, 37.9% had significant CAD on coronary angiography.ConclusionsThe cardiovascular disease burden is significant amongst DDKT waitlist candidates. Pretransplant cardiac screening may identify patients with significant CAD at higher risk of MACE.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9574435&blobtype=pdf
ISSN	26718790
Journal	Korean Journal of Transplantation [Korean J Transplant]
Volume Number	36
DOI	10.4285/kjt.22.0029
PubMed Central reference number	PMC9574435
Issue Number	3
PubMed reference number	36275988
e-ISSN	26718804
Language	English
Publisher	The Korean Society for Transplantation
Publisher Date	2022-09-01
Access Restriction	Open
Rights License	This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © 2022 The Korean Society for Transplantation
Subject Keyword	Kidney transplantation Cardiovascular diseases Echocardiography, Stress Myocardial perfusion imaging Coronary angiography
Content Type	Text
Resource Type	Article
Subject	Transplantation Immunology