Table
1: Changing
cardiovascular risk profile of the renal transplant recipient.
|
|
2001 |
2005 |
2010 |
2012 |
|
Age (S.D.) |
39.2
(3.1) |
41.7
(3.2) |
48.7
(3.3) |
50.8
(3.3) |
|
Co-morbidties CAD PVD Diabetes
mellitus Stroke |
5.8%
(n = 5) 10.4%
(n = 9) 9.3%
(n = 9) 0%
(n = 0) |
12.8%
(n = 10)* 14.1%
(n = 11) 19.2%
(n = 15)** 1.3%
(n = 1) |
31.2%
(n = 25)** 18.7%
(n = 15)* 27.5%
(n = 22)** 7.5%
(n = 6)** |
34.4%
(n = 42)** 21.3%
(n = 26)* 27.9%
(n = 34)** 9.8%
(n = 12)** |
|
BMI (kg/m2) <
30 30-35 >
35 |
100%
(n = 86) |
94.9%
(n = 74) 5.1%
(n = 4) |
72.5%
(n = 58)** 26.25%
(n = 21) 1.25%
(n = 1) |
64.8%
(n = 79)** 27.0%
(n = 33) 8.2%
(n = 10) |
|
Smoker (%) |
40.7%
(n = 35) |
32.1%
(n = 25)* |
25.0%
(n = 20)** |
24.5%
(n = 30) |
|
Abnormal Resting ECG |
5.8%
(n = 5) |
12.8%
(n = 10)* |
26.2%
(n = 21)** |
25.4%
(n = 31)** |
|
Exercise tolerance test Failed
to complete 10 mins Bruce protocol/achieve target
heart rate ECG
changes consistent with ischaemia |
5.6%
(n = 1) 5.6%
(n = 1) |
12.0%
(n = 3) 16.0%
(n = 4)* |
45.5%
(n = 25)** 27.3%
(n = 15)** |
40.3%
(n = 25)** 33.9%
(n = 21)** |
|
Echocardiography LV
ejection fraction < 50% Left
ventricular hypertrophy Valvular heart disease |
0%
(n = 0) 33.3%
(n = 4) 0%
(n = 0) |
0%
(n = 0) 23.8%
(n = 12) 0%
(n = 0) |
2.2%
(n = 1) 55.6%
(n = 25)* 0%
(n = 0) |
5.8%
(n = 3)** 42.3%
(n = 22)* 0%
(n = 0) |
|
NHYA functional status 1 2 3 4 |
60.5%
(n = 52) 39.5%
(n = 34) |
52.5%
(n = 41) 41.0%
(n = 32) 6.4%
(n = 5) |
26.2%
(n = 21)** 60.0%
(n = 48) 13.8%
(n = 11) |
25.4%
(n = 31)** 53.8%
(n = 65) 21.3%
(n = 26) |
|
ASA 3 4 |
100%
(n = 86) |
100%
(n = 78) |
100%
(n = 80) |
97.5%
(n = 120) 2.5%
(n = 2) |
Results
are displayed as the percentage of the total transplant population/ year with
each risk factor (or percentage of patients who had imaging with a positive result
in cases when the whole population were not imaged). Coronary artery disease
(CAD) was defined as previous myocardial infarction or symptomatic coronary
artery disease with angiographic changes of stenosis > 50% in any vessel.
Peripheral vascular disease (PVD) was defined as intermittent claudication with
claudication disease < 50 metres, critical ischaemia or previous major lower limb amputation.
Hypertension was defined as a systolic blood pressure repeatedly > 140/90.
Diabetes was defined as two fasting blood sugars > 7 mmol/l.
Hyperlipidaemia was defined as a fasting cholesterol
> 5 mmol/l. Significant valvular
heart disease was defined as a gradient across the aortic valve > 30 mmHg or
> 5 mmHg across the mitral valve. Left ventricular hypertrophy on echo was
defined as a left ventricular mass index > 150 g/m2. ASA is the
American Society of Anaesthetics classification of peri-operative risk. All results were compared to 2001 as
the baseline. *indicates a statistically significant difference from
baseline (p < 0.05) and **indicates a highly statistically
significant difference (p < 0.001) (Reproduced from Aitken, et al., 2013).