COMPLICATIONS - CARDIOVASCULAR

Y. Caliskan¹, N. Alpay¹, T. Akagun¹, B. Toz¹, E. Kara¹, F. Tufan², G. Guz³, N. Polat³, H. Oflaz³, A. Turkmen¹, M.S. Sever^1
1Department Of Internal Medicine, Division Of Nephrology, Istanbul University, Istanbul Faculty of Medicine, Istanbul/TURKEY, ²Department Of Internal Medicine, Division Of Geriatrics, Istanbul University, Istanbul Faculty of Medicine, Istanbul/TURKEY, ³Department Of Cardiology, Istanbul University, Istanbul Faculty of Medicine, Istanbul/TURKEY

Body: Introduction: Cardiovascular diseases are still the major cause of death among renal transplant recipients. Coronary flow reserve (CFR) impairment is an early marker of subclinical coronary atherosclerosis and associated with endothelial dysfunction. In this prospective study, we aimed to investigate the long-term prognostic value of CFR and carotid intima media thickness (IMT) in renal transplant recipients without known coronary artery disease. Method: A total of 20 renal transplant recipients [13 male, 7 female, mean age: 33±9 (20-50) years] were included in this prospective follow up study. CFR recordings were performed by trans-thoracic Doppler echocardiography (TTDE). Carotid IMT was also measured in all patients. Serum levels of biochemical markers including serum glucose, BUN, creatinine, electrolytes, uric acid, calcium, phosphorus, total protein, albumin and total, LDL and HDL cholesterol levels were measured. Associations among these variables were analyzed. Results: During a follow up of three years, 2 patients died of malignancy and 3 of them lost to follow up. Only 1 patient, who underwent coronary angiography because of new-onset angina, had experience of cardiac event. The CFR value of this patient was 1.17 which means a severe CFR impairment. The baseline CFR and carotid IMT values of the patients were 1.77±0.48 and 0.67±0.15, respectively. After three years of follow up, there were no significant differences with regard to CFR (1.74±0.33, p=0.147) and IMT (0.67±0.09, p=0,376) values compared to baseline values. The differences in serum creatinine, total cholesterol and total protein levels after three years were also not significant. The CFR value at the third year of follow up, significantly correlated with age (r=-0.607, p=0.021), IMT at baseline (r=-0.739, p=0.004) and the third year (r=-0.541, p=0.046). In multivariate analysis, baseline carotid IMT (β=−0.562, p=0.05) was a significant independent predictor of CFR at the third year. Conclusion: Carotid IMT has a greater predictive value for impaired CFR in renal transplant recipients. Because of the small number of patients and cardiac events in this study, CFR was not found to be an independent predictor for future cardiovascular events in renal transplant recipients.

Disclosure: All authors have declared no conflicts of interest.