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학술저널
저자정보
Swati Vijayan (Lee Kong Chian School of Medicine Nanyang Technological University Singapore) Quan Yao Ho (Department of Renal Medicine Singapore General Hospital SingaporeSingHealth Duke-NUS Transplant Cen) Choong Hou Koh (Department of Cardiology National Heart Centre Singapore) Ian Tatt Liew (Department of Renal Medicine Singapore General Hospital SingaporeSingHealth Duke-NUS Transplant Cen) Sobhana Thangaraju (Department of Renal Medicine Singapore General Hospital SingaporeSingHealth Duke-NUS Transplant Cen) Ningyan Wong (Department of Cardiology National Heart Centre Singapore) Yann Shan Keh (Department of Cardiology National Heart Centre Singapore) Zi Hui Sharel Ong (Department of Renal Medicine Singapore General Hospital SingaporeSingHealth Duke-NUS Transplant Cen) Jia Qin Tan (Department of Renal Medicine Singapore General Hospital SingaporeSingHealth Duke-NUS Transplant Cen) Khung Keong Yeo (Department of Cardiology National Heart Centre Singapore) Terrance Siang Jin Chua (Department of Cardiology National Heart Centre Singapore) Terence Kee (Department of Renal Medicine Singapore General Hospital SingaporeSingHealth Duke-NUS Transplant Cen)
저널정보
대한이식학회 Clinical Transplantation and Research Korean Journal of Transplantation Vol.36 No.3
발행연도
2022.9
수록면
187 - 196 (10page)
DOI
10.4285/kjt.22.0029

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Background: Cardiac 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. Methods: This 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. Results: Of 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. Conclusions: The cardiovascular disease burden is significant amongst DDKT waitlist candidates. Pretransplant cardiac screening may identify patients with significant CAD at higher risk of MACE.
#Kidney transplantation #Cardiovascular diseases #Echocardiography #Stress #Myocardial perfusion imaging #Coronary angiography

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