BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death with a functioning graft in renal transplant recipients. The purpose of this study was to compare Framingham Risk Score (FRS), metabolic syndrome (MS), and cardiovascular events (CVE) in patients receiving early corticosteroid withdrawal (ECSWD), or chronic corticosteroid therapy (CCS). METHODS: In all, 251 ECSWD and 146 CCS patients were evaluated. FRS and MS were identified at baseline, six, 12, and 24 months post-transplant. A total of 124 patients with diabetes mellitus prior to transplantation were excluded from MS analysis. CVE were defined as sudden-death, MI, angina, or CVA/TIA. Repeat-measure logistic regression was used for statistical analysis. RESULTS: Fifty-four patients experienced 72 CVE. Mean follow-up was 755 +/- 312 d and time to CVE was 14.8 +/- 8.3 months. Demographics were similar between groups. FRS was not different between groups. CVE were significantly greater in CCS patients then ECSWD (20% vs. 10%, p = 0.024). New-onset MS occurred more frequently in patients receiving CCS then ECSWD (45% vs. 22%, p < 0.001) and was associated with more CVE (p < 0.015). CONCLUSIONS: Patients receiving ECSWD regimens have significantly decreased CVE and new onset MS compared with CCS. MS is associated with increased CV risk and CVE.
BACKGROUND:Cardiovascular disease (CVD) is the leading cause of death with a functioning graft in renal transplant recipients. The purpose of this study was to compare Framingham Risk Score (FRS), metabolic syndrome (MS), and cardiovascular events (CVE) in patients receiving early corticosteroid withdrawal (ECSWD), or chronic corticosteroid therapy (CCS). METHODS: In all, 251 ECSWD and 146 CCSpatients were evaluated. FRS and MS were identified at baseline, six, 12, and 24 months post-transplant. A total of 124 patients with diabetes mellitus prior to transplantation were excluded from MS analysis. CVE were defined as sudden-death, MI, angina, or CVA/TIA. Repeat-measure logistic regression was used for statistical analysis. RESULTS: Fifty-four patients experienced 72 CVE. Mean follow-up was 755 +/- 312 d and time to CVE was 14.8 +/- 8.3 months. Demographics were similar between groups. FRS was not different between groups. CVE were significantly greater in CCSpatients then ECSWD (20% vs. 10%, p = 0.024). New-onset MS occurred more frequently in patients receiving CCS then ECSWD (45% vs. 22%, p < 0.001) and was associated with more CVE (p < 0.015). CONCLUSIONS:Patients receiving ECSWD regimens have significantly decreased CVE and new onset MS compared with CCS. MS is associated with increased CV risk and CVE.
Authors: Nathaniel D Bayer; Philip T Cochetti; Mysore S Anil Kumar; Valerie Teal; Yonghong Huan; Cataldo Doria; Roy D Bloom; Sylvia E Rosas Journal: Transplantation Date: 2010-10-27 Impact factor: 4.939
Authors: Muhammad A Mujtaba; Tim E Taber; William C Goggins; Muhammad S Yaqub; Dennis P Mishler; Martin L Milgrom; Jonathan A Fridell; Andrew Lobashevsky; John A Powelson; Asif A Sharfuddin Journal: Clin J Am Soc Nephrol Date: 2010-11-04 Impact factor: 8.237
Authors: Sunjae Bae; Jacqueline M Garonzik Wang; Allan B Massie; Kyle R Jackson; Mara A McAdams-DeMarco; Daniel C Brennan; Krista L Lentine; Josef Coresh; Dorry L Segev Journal: J Am Soc Nephrol Date: 2019-12-18 Impact factor: 10.121
Authors: L E Nikkel; S Mohan; A Zhang; D J McMahon; S Boutroy; G Dube; B Tanriover; D Cohen; L Ratner; C S Hollenbeak; M B Leonard; E Shane; T L Nickolas Journal: Am J Transplant Date: 2011-12-07 Impact factor: 8.086
Authors: Tracey E Toms; Vasileios F Panoulas; Karen M J Douglas; Helen R Griffiths; George D Kitas Journal: Arthritis Res Ther Date: 2008-12-17 Impact factor: 5.156