Screening for significant coronary artery disease in high-risk renal transplant candidates
| Autor: | José Antonio Franchini Ramires, Flávio Jota de Paula, Luis Henrique W. Gowdak, Eduardo M. Krieger, José Jayme Galvão de Lima, Luiz Antonio Machado César, Eulógio Emílio Martinez Filho, Luiz Estevan Ianhez |
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| Rok vydání: | 2007 |
| Předmět: |
Male
Risk medicine.medical_specialty Time Factors Cost-Benefit Analysis Cardiology Coronary Artery Disease Coronary Angiography Angina Coronary artery disease Renal Dialysis Diabetes mellitus Internal medicine medicine Odds Ratio Humans Mass Screening cardiovascular diseases Myocardial infarction Mass screening Aged Framingham Risk Score Models Statistical business.industry General Medicine Odds ratio Middle Aged medicine.disease Kidney Transplantation Cardiovascular Diseases Kidney Failure Chronic Female Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | ResearcherID |
| ISSN: | 0954-6928 |
| Popis: | BACKGROUND: Renal transplant candidates are at an increased risk for coronary artery disease (CAD), a strong predictor of cardiovascular events [major adverse coronary events (MACE)]. Coronary angiography is a costly, risky, invasive procedure. We sought to determine clinical predictors of significant CAD (stenosis > or =70%) in high-risk renal transplant candidates. METHODS: Clinical evaluation and coronary angiography were performed in 301 patients (57+/-8 years, 73% men) on hemodialysis for 32 months (median). Patients were followed-up for 22 months (median). Inclusion criteria were diabetes (type 1 or 2), evidence of cardiovascular disease, or age > or =50 years. Risk factors included hypertension (93.7%), overweight/obesity (54.3%), dyslipidemia (44.9%), diabetes (42.1%), and smoking (24.3%). Cardiovascular disease was found as follows: peripheral arterial disease (PAD) (31.2%), angina (28.1%), stroke (12.9%), myocardial infarction (MI) (10.3%), and heart failure (9.3%). RESULTS: Significant CAD was found in 136 individuals (45.2%). Diabetes [odds ratio (OR)=1.82; 95% confidence interval (CI)=1.08-3.07], PAD (OR=2.50; 95% CI=1.44-4.37), and previous MI (OR=7.75; 95% CI=3.03-23.98) were associated with significant CAD. The prevalence of significant CAD increased with the number of clinical predictors from 26% (none) to 100% (all present) (P |
| Databáze: | OpenAIRE |
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