Incidence and predictors of myocardial infarction after kidney transplantation

Krista L. Lentine, Daniel Brennan, Mark A. Schnitzler

Research output: Contribution to journalArticle

Abstract

The risk and predictors of post-kidney transplantation myocardial infarction (PTMI) are not well described. Registry data collected by the United States Renal Data System were used to investigate retrospectively PTMI among adult first renal allograft recipients who received a transplant in 1995 to 2000 and had Medicare as the primary payer. PTMI events were ascertained from billing and death records, and participants were followed for up to 3 yr after transplant or until the end of observation (December 31, 2000). Extended Cox's hazards analysis was used to identify independent clinical correlates of PTMI (hazard ratio [HR]) and to examine PTMI as an outcomes predictor. Among 35,847 eligible participants, the cumulative incidence of PTMI was 4.3% (95% confidence interval [CI], 4.1 to 4.5%), 5.6% (95% CI, 5.3 to 5.8%), and 11.1% (95% CI, 10.7 to 11.5%) at 6,12, and 36 mo, respectively. Risk factors for PTMI included older recipient age, pretransplantation comorbidities (diabetes, angina, peripheral vascular disease, and MI), transplantation from older donors and deceased donors, and delayed graft function. Women, blacks, Hispanics, and employed recipients experienced reduced risk. The hazard of PTMI rose after a diagnosis of posttransplantation diabetes (HR, 1.60; 95% CI, 1.35 to 1.88) and markedly increased after graft failure (HR, 2.78; 95% CI, 2.41 to 3.19). In separate analyses, PTMI predicted death-censored graft failure (HR, 1.89; 95% CI, 1.63 to 2.20) and strongly predicted death in a manner that declined with time after PTMI. Risk factors for PTMI include potentially modifiable posttransplantation complications. Because PTMI in turn predicts graft failure and death, reducing the risk for PTMI may improve outcomes after kidney transplantation.

Original languageEnglish (US)
Pages (from-to)496-506
Number of pages11
JournalJournal of the American Society of Nephrology
Volume16
Issue number2
DOIs
StatePublished - Dec 12 2005
Externally publishedYes

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Kidney Transplantation
Myocardial Infarction
Incidence
Confidence Intervals
Transplants
Tissue Donors
Delayed Graft Function
Kidney
Death Certificates
Peripheral Vascular Diseases
Medicare
Hispanic Americans
Information Systems
Allografts
Registries
Comorbidity
Transplantation
Observation

ASJC Scopus subject areas

  • Nephrology

Cite this

Incidence and predictors of myocardial infarction after kidney transplantation. / Lentine, Krista L.; Brennan, Daniel; Schnitzler, Mark A.

In: Journal of the American Society of Nephrology, Vol. 16, No. 2, 12.12.2005, p. 496-506.

Research output: Contribution to journalArticle

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