PDF(Pubmed)
Abstract：
UNASSIGNED: Cardiovascular disease is a significant cause of mortality after kidney transplantation. Whether pre-transplant screening for coronary artery disease (CAD) in asymptomatic kidney transplant candidates (KTCs) is beneficial is unclear.
UNASSIGNED: We conducted a retrospective cohort study evaluating post-transplant cardiovascular events in 192 high-risk KTCs who underwent pre-transplant CAD evaluation. The study aimed to identify risk factors associated with finding severe CAD on pre-transplant angiography, and to assess the relationship between screening strategies and post-transplant cardiovascular events.
UNASSIGNED: At five years post-transplant, cardiovascular events occurred in 23.9% of subjects. Prior CAD history and left ventricular ejection fraction (LVEF) < 50% were associated with higher odds of finding severe CAD on pre-transplant angiography. Severe CAD on angiography was associated with a higher risk of early cardiovascular events within six months of transplantation. However, coronary intervention in KTCs with severe CAD was not associated with lower rates of post-transplant cardiovascular events.
UNASSIGNED: Pre-transplant coronary angiography to identify severe CAD is of highest yield in KTCs with a history of CAD or an LVEF < 50%. Our findings indicate that the identification of severe CAD in KTCs has prognostic significance for the early post-transplant period. Optimization of medical therapy in these high-risk KTCs may improve post-transplant cardiovascular outcomes.
UNASSIGNED: We conducted a retrospective cohort study evaluating post-transplant cardiovascular events in 192 high-risk KTCs who underwent pre-transplant CAD evaluation. The study aimed to identify risk factors associated with finding severe CAD on pre-transplant angiography, and to assess the relationship between screening strategies and post-transplant cardiovascular events.
UNASSIGNED: At five years post-transplant, cardiovascular events occurred in 23.9% of subjects. Prior CAD history and left ventricular ejection fraction (LVEF) < 50% were associated with higher odds of finding severe CAD on pre-transplant angiography. Severe CAD on angiography was associated with a higher risk of early cardiovascular events within six months of transplantation. However, coronary intervention in KTCs with severe CAD was not associated with lower rates of post-transplant cardiovascular events.
UNASSIGNED: Pre-transplant coronary angiography to identify severe CAD is of highest yield in KTCs with a history of CAD or an LVEF < 50%. Our findings indicate that the identification of severe CAD in KTCs has prognostic significance for the early post-transplant period. Optimization of medical therapy in these high-risk KTCs may improve post-transplant cardiovascular outcomes.
摘要：
■心血管疾病是肾移植后死亡的重要原因。目前尚不清楚无症状肾移植患者（KTC）的移植前冠状动脉疾病（CAD）筛查是否有益。
我们进行了一项回顾性队列研究，评估了192例接受移植前CAD评估的高危KTC的移植后心血管事件。该研究旨在确定与在移植前血管造影中发现严重CAD相关的危险因素，并评估筛查策略与移植后心血管事件之间的关系。
■移植后五年，23.9%的受试者发生心血管事件.先前的CAD病史和左心室射血分数（LVEF）<50％与移植前血管造影发现严重CAD的较高几率相关。血管造影的严重CAD与移植后6个月内早期心血管事件的高风险相关。然而,KTC合并重度CAD的冠状动脉介入治疗与较低的移植后心血管事件发生率无关.
■在有CAD病史或LVEF<50％的KTC中，移植前冠状动脉造影以识别严重CAD的产量最高。我们的发现表明，在KTC中识别出严重的CAD对移植后的早期具有预后意义。在这些高风险KTC中优化药物治疗可能会改善移植后的心血管结局。
我们进行了一项回顾性队列研究，评估了192例接受移植前CAD评估的高危KTC的移植后心血管事件。该研究旨在确定与在移植前血管造影中发现严重CAD相关的危险因素，并评估筛查策略与移植后心血管事件之间的关系。
■移植后五年，23.9%的受试者发生心血管事件.先前的CAD病史和左心室射血分数（LVEF）<50％与移植前血管造影发现严重CAD的较高几率相关。血管造影的严重CAD与移植后6个月内早期心血管事件的高风险相关。然而,KTC合并重度CAD的冠状动脉介入治疗与较低的移植后心血管事件发生率无关.
■在有CAD病史或LVEF<50％的KTC中，移植前冠状动脉造影以识别严重CAD的产量最高。我们的发现表明，在KTC中识别出严重的CAD对移植后的早期具有预后意义。在这些高风险KTC中优化药物治疗可能会改善移植后的心血管结局。
