Cardiology Department, General Hospital of Athens "Laiko", Athens, Greece.
Cardiology Department, General Hospital of Athens "Laiko", Athens, Greece.
Hellenic J Cardiol. 2020 May-Jun;61(3):199-203. doi: 10.1016/j.hjc.2018.07.002. Epub 2018 Jul 6.
Cardiovascular disease is the leading cause of mortality in renal transplant recipients (RT). Coronary artery disease (CAD) in such patients is poorly studied.
During 2012-2017, 50 patients with a renal graft (functioning for a minimum of 6 months) were subjected to coronary angiography in our institution. They were matched (for age, gender, diabetes, and indication for angiography) with 50 patients with end-stage renal disease (ESRD) undergoing chronic dialysis and 50 patients with normal renal function who were subjected to coronary angiography during the same period. The extent and severity of CAD were assessed by using the SYNTAX score.
RT had a significantly longer duration of ESRD than patients on dialysis (17.5±7.1 vs. 8.5±8.7 years, p<0.01). Mean SYNTAX score was 13.3±12.0 in RT, 20.6±17.5 in patients on dialysis, and 9.4±9.2 in control patients (p<0.01). At least one significantly calcified lesion was present in 75.7% of RT recipients, 92.1% of patients on dialysis, and 15.8% of control patients (p<0.01). Percutaneous coronary intervention (PCI) was successful in 93.8% of the attempted cases in RT, 75% of patients on chronic dialysis, and 100% of control patients (p=0.04). In the RT group, SYNTAX score significantly correlated with smoking (p=0.02) and the total vintage of ESRD (p=0.04).
In this angiographic study, CAD was less severe in RT than in patients on long-term dialysis despite a longer duration of ESRD. Coronary artery calcification was highly prevalent after renal transplantation. PCI in RT had a high rate of angiographic success.
心血管疾病是肾移植受者（RT）死亡的主要原因。此类患者的冠状动脉疾病（CAD）研究甚少。
在 2012 年至 2017 年期间，我院对 50 例有肾移植（至少 6 个月）的患者进行了冠状动脉造影。为了与年龄、性别、糖尿病和血管造影指征相匹配，我们选择了 50 例接受慢性透析的终末期肾病（ESRD）患者和 50 例同期进行冠状动脉造影的肾功能正常患者。采用 SYNTAX 评分评估 CAD 的严重程度。
RT 的 ESRD 持续时间明显长于透析患者（17.5±7.1 年 vs. 8.5±8.7 年，p<0.01）。RT 患者的平均 SYNTAX 评分为 13.3±12.0，透析患者为 20.6±17.5，对照组为 9.4±9.2（p<0.01）。75.7%的 RT 受者、92.1%的透析患者和 15.8%的对照组至少有一个明显钙化病变（p<0.01）。RT 组中有 93.8%的尝试病例进行了成功的经皮冠状动脉介入治疗（PCI），透析组中有 75%，对照组中有 100%（p=0.04）。在 RT 组中，SYNTAX 评分与吸烟（p=0.02）和 ESRD 总病程（p=0.04）显著相关。
在这项血管造影研究中，尽管 ESRD 持续时间较长，但 RT 患者的 CAD 严重程度低于长期透析患者。肾移植后冠状动脉钙化非常普遍。RT 中的 PCI 具有很高的血管造影成功率。
