MedStar Authors catalog › Details for: Pre-operative cardiovascular testing and post-renal transplant clinical outcomes.
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Pre-operative cardiovascular testing and post-renal transplant clinical outcomes.

by Yang, Michael; Miller, Patrick J; Case, Brian C; Widell, Jared K; Rogers, Toby; Satler, Lowell F; Waksman, Ron; Ben-Dor, Itsik.
Citation: Cardiovascular Revascularization Medicine. 2019 Apr 17.Journal: Cardiovascular revascularization medicine : including molecular interventions.Published: ; 2019ISSN: 1878-0938.Full author list: Yang M; Miller PJ; Case BC; Gilbert AJ; Widell JK; Rogers T; Satler LF; Waksman R; Ben-Dor I.UI/PMID: 31097384.Subject(s): IN PROCESS -- NOT YET INDEXEDInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1016/j.carrev.2019.04.017 (Click here) Abbreviated citation: Cardiovasc Revasc Med. 2019 Apr 17.Abstract: BACKGROUND: Cardiovascular disease, a major contributor to morbidity and mortality in chronic kidney disease and kidney transplant patients, is closely evaluated before kidney transplant. We aimed to characterize pre-transplant cardiac testing practices and post-transplant cardiac outcomes at a single academic center.Abstract: METHODS: This was a retrospective, single-center analysis of consecutive adults receiving first renal transplant from 1/1/2016 to 6/31/2017. Data included demographics, medical history, and medications. Pre-transplant workup included echocardiograms, cardiac stress testing, coronary computed tomography, left heart catheterization (LHC), and any revascularization. Outcomes included all-cause mortality, cardiac mortality, myocardial infarction (MI), and myocardial injury.Abstract: RESULTS: Our analysis included 235 patients with mean follow-up of 1.6+/-0.53years. Of these, 219 (93%) patients had non-invasive functional testing before transplant, with 198 normal and 21 abnormal. The most common modalities were dobutamine stress echocardiogram (88) and pharmacological myocardial perfusion imaging (60). Twenty-four (10%) patients had an LHC, including 14 abnormal studies, and 10 who subsequently underwent successful revascularization. There were 3 deaths, 2 that were cardiac-specific. There were no ST-elevation MIs and 1 Type I non-ST-elevation MI (NSTEMI), occurring 2days after transplant. Of those patients with a 30-day post-operative troponin, 30 (13%) patients had an elevation due to a type II NSTEMI or myocardial injury.Abstract: CONCLUSIONS: Non-invasive functional testing is common prior to renal transplantation, with most being normal. Few patients are revascularized before transplantation. Perioperative death and acute coronary syndrome are rare, but troponin elevations due to type II NSTEMI and myocardial injury are common.Abstract: Copyright (c) 2019 Elsevier Inc. All rights reserved.

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