Coronary artery disease in a large renal transplant population: implications for management.

摘要: Coronary artery disease (CAD) accounts for approximately one-half of the sizable mortality in patients with end-stage renal who have undergone transplantation. The study was a retrospective review 1460 underwent transplantation at Mount Sinai Medical Center from January 1, 2000 to October 31, 2009. Noninvasive stress testing performed 848 (88.1%) 278 (32.8%) having abnormal results. Cardiac catheterization 357 (37.1%) and these, 212 had obstructive (59.4%). At 5 years posttransplant, there no statistically significant difference between those nonobstructive CAD required percutaneous or surgical interventions (adjusted hazard ratio [aHR], 1.243; CI 95%, 0.513–3.010; p = 0.630). Those medically managed significantly higher rates death 5-year period when compared received intervention (aHR, 3.792; 1.320–10.895; 0.013) coronary bypass grafting 6.691; 1.200–37.323). Because noninvasive imaging is poorly predictive this high-risk population, an anatomic diagnosis recommended. Revascularization may result improved long-term outcomes.