Coronary calcifications predict cardiovascular events in renal transplant recipients

Body: Coronary arteries calcifications (CAC) independently predict cardiovascular events (CVE) in the general population.Whether this applies to renal transplant recipients (RTR) is unknown. This prospective study assessed the prognostic impact of CAC on cardiovascular mortality and all CVE in RTR. Methods: We followed a previously described cohort of 281 prevalent RTR (P.Nguyen AmJNephrol2007). At baseline, 16-slice chest spiral CT scan was performed and classical and CKD-related risk factors were recorded. Major CVE (MCVE) was defined as cardiac death, infarction, stroke or TIA. All CVE (ACVE) included MCVE and revascularizations. Prognostic factors were assessed using univariate and multivariate Cox regression. Results: During 2.4+-0.2 years follow-up, patients died from cardiac (n=8) or non cardiac causes (n=8). Thirty-one RTR developed at least one CVE (cardiac n=15, peripheral n=12, cerebrovascular n=4). Two-year cardiac survival and ACVE-free survival was 97.9% and 90.3% respectively. Log-scaled CAC was the only independent predictor of cardiac mortality (HR = 9.3 [2.0 44.4], p < 0.01). C-reactive protein serum level was the only independent predictor of MCVE. Multivariate predictors of ACVE were a higher log-scaled CAC (HR = 2.0 [1.2 3.3], p < 0.01) and a history of CVE (HR = 3.1 [1.3 7.5], p = 0.01)