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. 2022 Apr;22(4):1115-1122.
doi: 10.1111/ajt.16938. Epub 2022 Jan 12.

Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation

Julio C Santana  1 , Harish Doppalapudi  2   3 , Christopher W Ives  2 , Ayman A Farag  2 , Dana V Rizk  4 , Vineeta Kumar  4 , Ami E Iskandrian  2 , Fadi G Hage  2   3
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Free article

Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation

Julio C Santana et al. Am J Transplant. 2022 Apr.
Free article

Abstract

We have shown that silent myocardial infarction (SMI) on 12-lead ECG is associated with increased cardiovascular disease (CVD) risk in patients awaiting renal transplantation (RT). In this study, we evaluated the prevalence of SMI in patients undergoing RT and their prognostic value after RT. MI was determined by automated analysis of ECG. SMI was defined as ECG evidence of MI without a history of clinical MI (CMI). The primary outcome was a composite of CVD death, non-fatal MI and coronary revascularization after RT. Of the 1189 patients who underwent RT, a 12-lead ECG was available in >99%. Of the entire cohort 6% had a history of CMI while 7% had SMI by ECG. During a median follow-up of 4.6 years, 147 (12%) experienced the primary outcome (8% CVD death, 4% MI, 4% coronary revascularization) and 12% died. Both SMI and CMI were associated with an increased risk of CVD events and all-cause deaths. In a multivariable adjusted Cox-regression model, both SMI (adjusted hazard ratio 2.03 [1.25-3.30], p = .004) and CMI (2.15 [1.24-3.74], p = .007) were independently associated with the primary outcome. SMI detected by ECG prior to RT is associated with increased risk of CVD events after RT.

Keywords: cardiovascular disease; clinical research/practice; heart disease; kidney transplantation/nephrology; myocardial infarction.

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References

REFERENCES

    1. Chadban SJ, Ahn C, Axelrod DA, et al. KDIGO clinical practice guideline on the evaluation and management of candidates for kidney transplantation. Transplant. 2020;104(4S1):S11-S103.
    1. Hart A, Lentine KL, Smith JM, et al. OPTN/SRTR 2019 Annual data report: kidney. Am J Transplant. 2021;21(Suppl 2):21-137.
    1. Bourque JM, Iskandrian AE, Hage FG. Screening pre-renal transplant: risk factors appear key but important questions remain. J Nucl Cardiol. 2018;25(6):2069-2071.
    1. Lentine KL, Costa SP, Weir MR, et al. Cardiac disease evaluation and management among kidney and liver transplantation candidates: a scientific statement from the American Heart Association and the American College of Cardiology Foundation. J Am Coll Cardiol. 2012;60(5):434-480.
    1. Hage FG, Smalheiser S, Zoghbi GJ, et al. Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation. Am J Cardiol. 2007;100(6):1020-1025.

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