Liver Transpl. 2022 Feb 6. doi: 10.1002/lt.26425. Online ahead of print.
ABSTRACT
Cardiovascular disease (CVD) is an important cause of mortality among liver transplantation (LT) recipients, however, the data on CVD risk stratification following LT is limited. Thus, the primary aim of the current study was to evaluate the association between decline in renal function early after LT and atherosclerotic events.
METHOD: This retrospective study included all patients receiving LT between 2007 and 2019. Early renal function was quantified as estimated glomerular filtration rate (GFR) 6 months after LT. The primary endpoint for the study was a composite atherosclerotic cardiovascular event of 3-point major adverse cardiovascular events (MACE), which includes non-fatal myocardial infarction (MI), non-fatal stroke, or death from CVD.
RESULTS: A total of 553 LT recipients met entry criteria. After a median follow up of 74 months (IQR 46, 111), 94 (17%) LT recipients died and CVD associated death occurred in 20 patients. MACE-3 occurred in 66 (12%) with non-fatal myocardial infarction being the most common event (n=30). A strong inverse relationship between early GFR and MACE-3 was noted in unadjusted analysis with HR 0.96 (95% CI 0.95, 0.98, p=0.0001) and remained significant even after accounting for age, gender, coronary artery disease, diabetes, hypertension, calcineurin inhibitor use, and Framingham Risk Score (FRS) (HR 0.96, 95% CI 0.95, 0.97, p=0.0001 per unit increase in GFR). Furthermore, an independent interaction between GFR, FRS and likelihood of developing a MACE-3 was noted.
CONCLUSION: Glomerular filtration rate 6 months following LT is a strong predictor of developing atherosclerotic events. This relationship is independent of traditional CVD risk-stratification model (FRS), thus, has the potential to be incorporated into CVD risk assessment after LT but requires further validation.
PMID:35124881 | DOI:10.1002/lt.26425
