Objectives To determine the related risk factors for cardiovascular complication in first-year post-transplantation, and assess the ability of two standard cardiovascular risk scores developed for predicting cardiovascular events (CVE) in non-transplant populations to identify kidney transplant recipients with a higher CVE risk at the first year after transplantation.
Methods We reviewed 332 kidney transplant recipients, which had at least 1-year follow-up after transplantation in our centre in the period 2007-2010. Traditional and transplant-specific CVD risk factors were investigated, major CVE were captured. The impact of risk factors on CAE was estimated by Logistic regression analysis, and the ability of different cardiovascular risk scores (Framingham risk score and Chinese cardiovascular risk score) to predict cardiovascular events will be estimated by using Youden index and the area under ROC curves.
Results At the first year after transplantation, 6.3% of surviving patients experienced CVE, the occurance of coronary artery disease and congestive heart failure is 4.8%. There was a clear difference with the recipient’s body mass index (BMI) (P = 0.023), smoking (P = 0.006), SBP (P = 0.002), PTDM (P < 0.001), Total cholesterol (P = 0.015) and Proteinuria (P = 0.011) between CVE and non-CVE groups. In logistic regression analysis, risk factors associated with cardiovascular complications were post-transplantation hypertension (PTH) (HR = 2.394, P = 0.014), post-transplant hyperlipidemia (HR = 2.284, P = 0.002), abnormal renal function (HR = 3.795, P = 0.010), proteinuria (HR = 3.156, P = 0.023) and PTDM (HR = 3.547, P = 0.012). Areas under the curve of Framingham risk scores (FRS) and Chinese cardiovascular risk scores (CRS) to predict CAE in recipients were 0.724 and 0.693 (P > 0.05), respectively. And the Youden index in FRS and CRS was 0.633 and 0.688, respectively (P > 0.05). Compared with 0.5 critical value, the differences were statistical significance in both scores (P < 0.01).
Conclusions The control of modifiable cardiovascular risk factors in renal transplant recipients is suboptimal. Both scores can be used to identify kidney recipients at higher risk for CAE beyond the first year.