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Risk factors for cardiovascular disease in renal transplant recipients: new insights.
Transpl Int 2000; 13 Suppl 1:S419-24TI

Abstract

Long-term survival of renal transplant recipients appears to be influenced by the occurrence of thromboembolic complications and cardiovascular disease. In order to investigate the prevalence of new hemostasis-related risk factors for venous and arterial thrombosis, we investigated 63 renal transplant recipients and 66 age- and sex-matched control subjects. We assayed antiphospholipid antibodies [lupus anticoagulant (LA) and anticardiolipin antibodies (aCL)], lipoprotein (a) [Lp(a)], plasminogen activator inhibitor-1 (PAI-1), and total homocysteine (tHcy) levels. We found a significantly higher prevalence of positivity for LA (P < 0.001); no difference was detected in the prevalence of aCL between patients and controls. PAI-1 levels were significantly higher in renal transplant recipients than in controls [12.3 IU/ml (2-45.5) vs 7.9 IU/ml (4-18.0); P < 0.0001] with an odd ratio (OR) of 11.8 (4.9-28.5) in univariate analysis and of 5.8 (2.1-15.4) in multivariate analysis. Lp(a) levels were higher in patients then in controls [159 mg/l (1-992) vs 100.5 mg/l (10-412); P < 0.005] with an OR of 5.9 (1.9-18.4) in univariate analysis and of 3.5 (0.9-13.4) in multivariate analysis. Fasting levels of tHcy were significantly higher in renal transplant recipients [7.0 micromol/l (4.0-68) vs 8.1 micromol/l (2.0-24.0); P < 0.00001] with an OR of 40.4 (14.7-111) in univariate analysis and of 33.1 (11.1-115.5) in multivariate analysis. After methionine loading test, we documented levels of tHcy above the 90th percentile of controls in 60/63 patients (95%). Finally, we found a significant correlation between tHcy and PAI-1 plasma levels (r = 0.76; P < 0.000001). Our results show a high prevalence of hemostasis-related risk factors for arterial and venous thrombosis in renal transplant recipients, suggesting the need for the investigation of these patients for the presence of these risk factors in order to improve their long-term survival and to tailor therapy.

Authors+Show Affiliations

Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

11112046

Citation

Marcucci, R, et al. "Risk Factors for Cardiovascular Disease in Renal Transplant Recipients: New Insights." Transplant International : Official Journal of the European Society for Organ Transplantation, vol. 13 Suppl 1, 2000, pp. S419-24.
Marcucci R, Zanazzi M, Bertoni E, et al. Risk factors for cardiovascular disease in renal transplant recipients: new insights. Transpl Int. 2000;13 Suppl 1:S419-24.
Marcucci, R., Zanazzi, M., Bertoni, E., Brunelli, T., Fedi, S., Evangelisti, L., ... Salvadori, M. (2000). Risk factors for cardiovascular disease in renal transplant recipients: new insights. Transplant International : Official Journal of the European Society for Organ Transplantation, 13 Suppl 1, pp. S419-24.
Marcucci R, et al. Risk Factors for Cardiovascular Disease in Renal Transplant Recipients: New Insights. Transpl Int. 2000;13 Suppl 1:S419-24. PubMed PMID: 11112046.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for cardiovascular disease in renal transplant recipients: new insights. AU - Marcucci,R, AU - Zanazzi,M, AU - Bertoni,E, AU - Brunelli,T, AU - Fedi,S, AU - Evangelisti,L, AU - Pepe,G, AU - Rogolino,A, AU - Prisco,D, AU - Abbate,R, AU - Gensini,G F, AU - Salvadori,M, PY - 2000/12/9/pubmed PY - 2001/6/2/medline PY - 2000/12/9/entrez SP - S419 EP - 24 JF - Transplant international : official journal of the European Society for Organ Transplantation JO - Transpl. Int. VL - 13 Suppl 1 N2 - Long-term survival of renal transplant recipients appears to be influenced by the occurrence of thromboembolic complications and cardiovascular disease. In order to investigate the prevalence of new hemostasis-related risk factors for venous and arterial thrombosis, we investigated 63 renal transplant recipients and 66 age- and sex-matched control subjects. We assayed antiphospholipid antibodies [lupus anticoagulant (LA) and anticardiolipin antibodies (aCL)], lipoprotein (a) [Lp(a)], plasminogen activator inhibitor-1 (PAI-1), and total homocysteine (tHcy) levels. We found a significantly higher prevalence of positivity for LA (P < 0.001); no difference was detected in the prevalence of aCL between patients and controls. PAI-1 levels were significantly higher in renal transplant recipients than in controls [12.3 IU/ml (2-45.5) vs 7.9 IU/ml (4-18.0); P < 0.0001] with an odd ratio (OR) of 11.8 (4.9-28.5) in univariate analysis and of 5.8 (2.1-15.4) in multivariate analysis. Lp(a) levels were higher in patients then in controls [159 mg/l (1-992) vs 100.5 mg/l (10-412); P < 0.005] with an OR of 5.9 (1.9-18.4) in univariate analysis and of 3.5 (0.9-13.4) in multivariate analysis. Fasting levels of tHcy were significantly higher in renal transplant recipients [7.0 micromol/l (4.0-68) vs 8.1 micromol/l (2.0-24.0); P < 0.00001] with an OR of 40.4 (14.7-111) in univariate analysis and of 33.1 (11.1-115.5) in multivariate analysis. After methionine loading test, we documented levels of tHcy above the 90th percentile of controls in 60/63 patients (95%). Finally, we found a significant correlation between tHcy and PAI-1 plasma levels (r = 0.76; P < 0.000001). Our results show a high prevalence of hemostasis-related risk factors for arterial and venous thrombosis in renal transplant recipients, suggesting the need for the investigation of these patients for the presence of these risk factors in order to improve their long-term survival and to tailor therapy. SN - 0934-0874 UR - https://www.unboundmedicine.com/medline/citation/11112046/Risk_factors_for_cardiovascular_disease_in_renal_transplant_recipients:_new_insights_ L2 - https://medlineplus.gov/kidneytransplantation.html DB - PRIME DP - Unbound Medicine ER -