Prevalence, predictors, and outcomes of coronary artery disease diagnosed by angiography in live-related kidney transplant candidates.

BACKGROUND

Cardiac evaluation is critical pre-transplant to ensure better outcomes. This retrospective observational study aimed to determine the prevalence of coronary artery disease (CAD) and its predictors, and to study the impact of CAD on delayed graft function (DGF), acute rejection, graft loss, and mortality.

METHODS

The study included all successful transplant candidates older than 14 who underwent a pre-transplant coronary angiogram. Binary logistic regression models were constructed to identify factors associated with CAD, graft failure, and patient outcomes.

RESULTS

Of 259 patients, 120 (46.33%) kidney transplant recipients (KTRs) underwent angiography. Eighty-four (70%) had a normal angiogram. Twenty (17%) had single-vessel disease, 9 (8%) had two-vessel disease, and 7 (6%) had three-vessel disease. Of 164 lesions, 84 (51.8%) were < 20%, 33 (20.1%) were 20-49%, 15 (9.1%) were 50-70%, 28 (17.1%) were 70-99%, and 4 (2.4%) were occluded. Age > 50 (OR 8.73), elevated triglycerides (OR 1.87), and family history (OR 5.08) were significant predictors. CAD was associated with lower eGFR only at discharge (OR 0.92) but not at 6 months, 1, or 2 years. CAD had no significant impact on DGF, graft loss, rejection, or mortality.

CONCLUSION

CAD affects 30% of KTRs. Age, elevated triglyceride, and family history of CAD are the various predictors of CAD. CAD does not affect long-term outcomes.