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Cardiovascular risk and renal transplantation: post hoc analyses of the Assessment of Lescol in Renal Transplantation (ALERT) Study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (The ALERT study.)
(The ALERT Study)
(The ALERT Study)
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2005 (English)In: American Journal of Kidney Diseases, ISSN 0272-6386, Vol. 46, no 3, 529-36 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Renal transplantation is associated with an increased risk for premature cardiovascular disease. We analyzed the data in the placebo arm of Assessment of Lescol in Renal Transplantation (ALERT) to improve our understanding of the relationship between cardiovascular risk factors and outcomes in this unique population. METHODS: We performed Cox survival analysis for myocardial infarction, cardiac death, and noncardiac death in 1,052 patients recruited to the placebo arm of ALERT. These subjects were aged 30 to 75 years, had stable graft function at least 6 months after transplantation, had a serum total cholesterol level between 155 and 348 mg/dL (4 and 9 mmol/L), and were receiving cyclosporine-based immunosuppression. RESULTS: The results confirm previous studies. In multivariate analysis, preexisting coronary heart disease (hazard ratio [HR], 3.69; P < 0.001), total cholesterol level (HR, 1.55 per 50 mg/dL; P = 0.0045), and prior acute rejection (HR, 2.36; P = 0.0023) were independent risk factors. Conversely, independent risk factors for cardiac death were age (HR, 1.58 per decade; P = 0.0033), diabetes (HR, 3.35; P = 0.0002), ST-T changes on the ECG (HR, 3.17; P = 0.0004), and serum creatinine level (HR, 2.65 per milligram per deciliter; P < 0.0001). CONCLUSION: This analysis confirms that renal transplant recipients share risk factors for myocardial infarction and cardiac death with the general population. However, the pattern of risk factors and their relationship with outcomes is atypical, highlighting the unique nature of cardiovascular risk in transplant recipients.

Place, publisher, year, edition, pages
2005. Vol. 46, no 3, 529-36 p.
Keyword [en]
Cardiovascular risk, renal disease, transplantation
National Category
Urology and Nephrology
Research subject
URN: urn:nbn:se:uu:diva-104497DOI: 10.1053/j.ajkd.2005.05.014PubMedID: 16129216 OAI: oai:DiVA.org:uu-104497DiVA: diva2:219857
Available from: 2009-05-28 Created: 2009-05-28 Last updated: 2009-06-03Bibliographically approved

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