Factors in Cardiac Risk Stratification of Candidates for Renal Transplant

Abstract

Background

Renal transplant candidates are at high risk of fatal and nonfatal cardiac events.

Methods

This study evaluated five clinical risk factors – age at least 50 years, insulin-requiring diabetes mellitus, angina, congestive heart failure and an abnormal electrocardiogram (ECG) (excluding left ventricular hypertrophy) – that had been used in the first tier of a two-tiered prospectively applied risk stratification algorithm.

Results

Using multiple logistic regression analysis, age at least 50 years, abnormal ECG, and diabetes mellitus were independently predictive of cardiac death. Of the two remaining clinical risk factors, the presence of angina had independent predictive value for nonfatal cardiac events (myocardial infarction, coronary angioplasty, bypass surgery, and unstable angina). The independent predictive value of congestive heart failure approached statistical significance.

Conclusion

Clinical risk-factor analysis is helpful in identifying renal transplant candidates at high risk for fatal or nonfatal cardiac events.