Incidence of cardiovascular events and associated risk factors in kidney transplant patients: a competing risks survival analysis

BMC Cardiovascular Disorders

Research Article

Salvador Pita-Fernández¹  María Teresa Seoane-Pillado¹  Rocio Seijo-Bestilleiro¹  Sonia Pértega-Díaz¹  Vanesa Balboa-Barreiro¹  Cristina González-Martín¹  Constantino Fernández-Rivera²  Francisco Valdés-Cañedo²  Ángel Alonso-Hernández² 

[1] Clinical Epidemiology and Biostatistics Research Group, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña (CHUAC), SERGAS, Universidade da Coruña, Hotel de Pacientes 7ª Planta, C/As Xubias de Arriba, 84, 15006, A Coruña, Spain;Department of Nephrology, A Coruña Hospital, As Xubias 84, 15006, A Coruña, Spain;

关键词: Kidney transplantation;    Cardiovascular diseases;    Risk factors;    Survival analysis;   

DOI  :  10.1186/s12872-017-0505-6

 received in 2016-11-15, accepted in 2017-02-28,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe high prevalence of cardiovascular risk factors among the renal transplant population accounts for increased mortality. The aim of this study is to determine the incidence of cardiovascular events and factors associated with cardiovascular events in these patients.MethodsAn observational ambispective follow-up study of renal transplant recipients (n = 2029) in the health district of A Coruña (Spain) during the period 1981–2011 was completed. Competing risk survival analysis methods were applied to estimate the cumulative incidence of developing cardiovascular events over time and to identify which characteristics were associated with the risk of these events.Post-transplant cardiovascular events are defined as the presence of myocardial infarction, invasive coronary artery therapy, cerebral vascular events, new-onset angina, congestive heart failure, rhythm disturbances, peripheral vascular disease and cardiovascular disease and death. The cause of death was identified through the medical history and death certificate using ICD9 (390–459, except: 427.5, 435, 446, 459.0).ResultsThe mean age of patients at the time of transplantation was 47.0 ± 14.2 years; 62% were male. 16.5% had suffered some cardiovascular disease prior to transplantation and 9.7% had suffered a cardiovascular event. The mean follow-up period for the patients with cardiovascular event was 3.5 ± 4.3 years. Applying competing risk methodology, it was observed that the accumulated incidence of the event was 5.0% one year after transplantation, 8.1% after five years, and 11.9% after ten years. After applying multivariate models, the variables with an independent effect for predicting cardiovascular events are: male sex, age of recipient, previous cardiovascular disorders, pre-transplant smoking and post-transplant diabetes.ConclusionsThis study makes it possible to determine in kidney transplant patients, taking into account competitive events, the incidence of post-transplant cardiovascular events and the risk factors of these events. Modifiable risk factors are identified, owing to which, changes in said factors would have a bearing of the incidence of events.

【 授权许可】

CC BY   
© The Author(s). 2017