Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates
Background. Benefits of cardiac screening in kidney transplant candidates (KTC) will be dependent on the availability of effective interventions. We retrospectively evaluated characteristics and outcome of percutaneous coronary interventions (PCI) in KTC selected for revascularization by a cardiac s...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Journal of Transplantation |
| Online Access: | http://dx.doi.org/10.1155/2014/854397 |
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| author | Julian König Martin Möckel Eda Mueller Wolfgang Bocksch Seema Baid-Agrawal Nina Babel Ralf Schindler Petra Reinke Peter Nickel |
| author_facet | Julian König Martin Möckel Eda Mueller Wolfgang Bocksch Seema Baid-Agrawal Nina Babel Ralf Schindler Petra Reinke Peter Nickel |
| author_sort | Julian König |
| collection | DOAJ |
| description | Background. Benefits of cardiac screening in kidney transplant candidates (KTC) will be dependent on the availability of effective interventions. We retrospectively evaluated characteristics and outcome of percutaneous coronary interventions (PCI) in KTC selected for revascularization by a cardiac screening approach. Methods. In 267 patients evaluated 2003 to 2006, screening tests performed were reviewed and PCI characteristics correlated with major adverse cardiovascular events (MACE) during a follow-up of 55 months. Results. Stress tests in 154 patients showed ischemia in 28 patients (89% high risk). Of 58 patients with coronary angiography, 38 had significant stenoses and 18 cardiac interventions (6.7% of all). 29 coronary lesions in 17/18 patients were treated by PCI. Angiographic success rate was 93.1%, but procedural success rate was only 86.2%. Long lesions (P=0.029) and diffuse disease (P=0.043) were associated with MACE. In high risk patients, cardiac screening did not improve outcome as 21.7% of patients with versus 15.5% of patients without properly performed cardiac screening had MACE (P=0.319). Conclusion. The moderate procedural success of PCI and poor outcome in long and diffuse coronary lesions underscore the need to define appropriate revascularization strategies in KTC, which will be a prerequisite for cardiac screening to improve outcome in these high-risk patients. |
| format | Article |
| id | doaj-art-ce0f0574e99348ee92fdf428df5d3c18 |
| institution | Kabale University |
| issn | 2090-0007 2090-0015 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Transplantation |
| spelling | doaj-art-ce0f0574e99348ee92fdf428df5d3c182025-02-03T01:11:35ZengWileyJournal of Transplantation2090-00072090-00152014-01-01201410.1155/2014/854397854397Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant CandidatesJulian König0Martin Möckel1Eda Mueller2Wolfgang Bocksch3Seema Baid-Agrawal4Nina Babel5Ralf Schindler6Petra Reinke7Peter Nickel8Department of Cardiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Cardiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Cardiology and Angiology, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, GermanyDepartment of Cardiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Nephrology and Intensive Care, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Nephrology and Intensive Care, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Nephrology and Intensive Care, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Nephrology and Intensive Care, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyDepartment of Nephrology and Intensive Care, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, GermanyBackground. Benefits of cardiac screening in kidney transplant candidates (KTC) will be dependent on the availability of effective interventions. We retrospectively evaluated characteristics and outcome of percutaneous coronary interventions (PCI) in KTC selected for revascularization by a cardiac screening approach. Methods. In 267 patients evaluated 2003 to 2006, screening tests performed were reviewed and PCI characteristics correlated with major adverse cardiovascular events (MACE) during a follow-up of 55 months. Results. Stress tests in 154 patients showed ischemia in 28 patients (89% high risk). Of 58 patients with coronary angiography, 38 had significant stenoses and 18 cardiac interventions (6.7% of all). 29 coronary lesions in 17/18 patients were treated by PCI. Angiographic success rate was 93.1%, but procedural success rate was only 86.2%. Long lesions (P=0.029) and diffuse disease (P=0.043) were associated with MACE. In high risk patients, cardiac screening did not improve outcome as 21.7% of patients with versus 15.5% of patients without properly performed cardiac screening had MACE (P=0.319). Conclusion. The moderate procedural success of PCI and poor outcome in long and diffuse coronary lesions underscore the need to define appropriate revascularization strategies in KTC, which will be a prerequisite for cardiac screening to improve outcome in these high-risk patients.http://dx.doi.org/10.1155/2014/854397 |
| spellingShingle | Julian König Martin Möckel Eda Mueller Wolfgang Bocksch Seema Baid-Agrawal Nina Babel Ralf Schindler Petra Reinke Peter Nickel Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates Journal of Transplantation |
| title | Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates |
| title_full | Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates |
| title_fullStr | Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates |
| title_full_unstemmed | Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates |
| title_short | Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates |
| title_sort | risk stratified cardiovascular screening including angiographic and procedural outcomes of percutaneous coronary interventions in renal transplant candidates |
| url | http://dx.doi.org/10.1155/2014/854397 |
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