SP788CORONARY ARTERY CALCIFICATION AND MORTALITY IN RENAL TRANSPLANT RECIPIENTS; A FOLLOW-UP OF UP TO 9 YEARS

Abstract

Introduction and Aims: Coronary Artery Calcification (CAC) is an important risk factor for mortality in the general population. Whether this applies to renal transplant recipients unknown.We conducted a study to determine if CAC predicts mortality in incident renal transplant recipients. Methods:We followed up 178 consecutive renal transplant recipients. At baseline, multi-detector spiral computed tomography was performed to examine CAC. Angina pectoris was sought with the Rose questionnaire. The extent of calcification was measured by Agatston score. Myocardial perfusion scintigraphy was performed in patients with moderate and severe CAC. Further cardiologic work up was performed by a cardiologist and 12 patients had documented coronary artery disease at the end of the work up. The patients were follow up in the outpatient clinic, according to rutine schedule. At the end of the follow up period, we collected information about patients who were not attending to regular visit with telephone interviews. Prognostic factors for all cause mortality were assessed by univariate Cox regression. Results: Patients were mostly male (67.4%) and had a living donor renal transplant (83.1%). The mean follow up period was 81 (±20) months (median: 83 ; range 5-105 months). The mean age at the time of CT scan was 36.5 (±11.2), with a minimum age of 20 years and a maximum age of 68 years. The median time on transplantation was 53.5 (Range: 3-295) months. The median duration of time on renal replacement therapy for the patients were 16 (Range: 0-120) months. Diabetes was present in 6.2 % of the patients. Baseline CAC was present in 72 patients (40.4%), and mean CAC score was 113.7 ± 275.5 (median: 0 and range: 0-1712). At the end of the follow up period 10 (5.6 %) patients had died. Univariate Cox regression analysis showed that the precense of CAC , longer time on transplantation, higher age, presence of diabetes, lower calcium levels were associated with worst survival.We also looked at major cardiovascular events or cardiovascular death in patients free of cardiovascular disease. In this subgrup baseline CAC was not associated with cardiovascular events or death. Conclusions: According to univariate analysis presence of CAC is associated with all cause mortality in renal transplant recipients. (Table Presented).