Inflammation, coronary artery calcification and cardiovascular events in incident renal transplant recipients

被引:51
作者
Roe, Peter [1 ]
Wolfe, Megan [2 ]
Joffe, Marshall [3 ]
Rosas, Sylvia E. [1 ,4 ]
机构
[1] Dept Med, Renal Electrolyte & Hypertens Div, Philadelphia, PA USA
[2] Ctr Expt Therapeut, Philadelphia, PA USA
[3] Univ Penn, Ctr Clin Epidemiol & Biostat, Dept Biostat, Philadelphia, PA 19104 USA
[4] Philadelphia Vet Med Ctr, Philadelphia, PA USA
基金
美国国家卫生研究院;
关键词
Coronary calcification; EBCT; Renal transplant; Inflammation; C-reactive protein; BEAM COMPUTED-TOMOGRAPHY; BLOOD-CELL COUNT; C-REACTIVE PROTEIN; ACUTE MYOCARDIAL-INFARCTION; HEMODIALYSIS-PATIENTS; HEART-DISEASE; MORTALITY; RISK; ATHEROSCLEROSIS; CALCIUM;
D O I
10.1016/j.atherosclerosis.2010.05.016
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective: Coronary artery calcification (CAC) predicts cardiovascular events in the general population. We conducted a prospective study to determine if inflammatory markers were predictive of CAC and if CAC predicted cardiovascular events and mortality in incident renal transplant recipients. Methods: A prospective cohort of 112 asymptomatic incident renal transplant recipients who had no prior history of coronary artery revascularization or myocardial infarction had coronary calcifications measured early post-transplant and at least 18 months later by Agatston score and volume method. Results: The mean CAC score was 367.7(682.3). Inflammatory markers such as WBC and CRP were predictive of CAC severity. Recipients with cardiovascular events (n = 11) or death (n = 12) during the follow-up period had higher mean [675.1 (669.3) vs. 296.8 (669.0),p = 0.02] and median [434.8 vs. 28.9,p = 0.01] CAC score compared to those without them. Recipients with CAC score less than 100 had a better cumulative survival rate compared to the recipients with CAC score greater than 100 [95.1% vs. 82.3%, p = 0.03]. We found a significant unadjusted and adjusted association between CAC score and cardiovascular events and mortality. A quarter (25.9%) of recipients had CAC progression. Coronary calcification progression also predicted cardiovascular events and mortality after adjustment for diabetes and dialysis vintage. Conclusion: CAC is prevalent in renal recipients and is predictive of cardiovascular events and mortality. Coronary calcification progression is common and predict clinical outcomes. Inflammatory markers are predictive of CAC severity at time of transplant, but are not predictive of future cardiovascular event or mortality. Published by Elsevier Ireland Ltd.
引用
收藏
页码:589 / 594
页数:6
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