Is standardized cardiac assessment of asymptomatic high-risk renal transplant candidates beneficial?

Jeroen Aalten, Stijn A Peeters, Maureen J van der Vlugt, Andries J Hoitsma
Nephrology, Dialysis, Transplantation 2011, 26 (9): 3006-12

BACKGROUND: Perioperative cardiovascular events in renal transplantation are common and non-invasive cardiac stress tests are recommended in high-risk renal transplant candidates. In 2004, we introduced a standardized preoperative cardiac risk assessment programme with the aim of reducing perioperative cardiac events.

METHODS: Since 2004, all asymptomatic high-risk renal transplant candidates had to undergo non-invasive cardiac stress testing. Patients with a positive stress test went for a coronary angiography and if indicated for revascularization. The incidence of perioperative cardiac events (≤30 days of transplantation) was analysed in all high-risk patients who received a transplantation (screening group) and compared with high-risk renal transplant recipients evaluated in the 4 years before the introduction of the cardiac assessment programme (historical control group).

RESULTS: Since 2004, 227 of 349 asymptomatic high-risk renal transplant candidates underwent non-invasive cardiac stress testing. In 15 patients (6.6%), significant ischaemia was found. Ten of these 15 patients underwent coronary angiography (eight patients had significant coronary artery disease and in five patients, percutaneous coronary intervention was performed). One hundred and sixty of 349 renal transplant candidates have received renal transplantation so far (screening group). In the screening group, 6 perioperative cardiac events (3.8%) occurred compared to 13 perioperative events (7.6%) in the historical control group (n = 172) (P = 0.136).

CONCLUSIONS: The incidence of significant cardiac ischaemia in high-risk renal transplant patients was low and was followed by revascularization in a small percentage of patients. No significant decrease in perioperative cardiac events was observed after the introduction of the standardized cardiac assessment programme.


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Available on the App Store

Available on the Play Store
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"