Cardiovascular disease: Risk factors and applicability of a risk model in a Greek cohort of renal transplant recipients

Table 1 Demographics, clinical characteristics and laboratory parameters in all renal transplant recipients and among the two groups

	Total	Group A	Group B	P
No. of patients (n, %)	242	206 (85.1)	36 (15)
Age (yr)	53 ± 12	52 ± 12	59 ± 10	< 0.001
Male sex (n, %)	154 (63.6)	126 (61.2)	28 (77.8)	0.056
Previous smoker (n, %)	85 (35.1)	69 (33.5)	16 (44.4)	0.2
Current smoker (n, %)	43 (17.8)	37 (17.5)	7 (19.4)	0.77
Hypertension (n, %)	212 (87.6)	178 (86.4)	34 (94.4)	0.56
Systolic BP (mmHg)	140 ± 18	141 ± 18	137 ± 19	0.25
Diabetes mellitus (n, %)	71 (29.3)	57 (27.7)	14 (38.8)	0.17
Previous CVD (n, %)	47 (19.4)	31 (15)	16 (44.4)	< 0.001
Time on dialysis (yr)	4.8 ± 3.9	4.7 ± 3.6	5.6 ± 3.8	0.16
Received allografts > 1 (n, %)	24 (9.9)	22 (10.7)	2 (5.6)	0.6
Time since transplant (mo)	9.8 ± 5.3	9.7 ± 5.3	10.5 ± 5.2	0.43
Creatinine (mg/dL)	1.45 ± 0.6	1.45 ± 0.57	1.44 ± 0.45	0.95
eGFR-MDRD (mL/min per 1.73 m2)	51.9 ± 17.2	51.9 ± 17.3	52.1 ± 17.2	0.97
Urine protein (mg/24 h)	309 (167-600)	325 (166-604)	290 (189-374)	0.76
Total cholesterol (mg/dL)	209 ± 33	212 ± 34	194 ± 25	0.08
LDL (mg/dL)	107 ± 35	107 ± 37	103 ± 27	0.56
Haemoglobin (g/dL)	13.1 ± 1.7	13.1 ± 1.7	13.3 ± 1.7	0.61
Calcium (mg/dL)	9.56 ± 0.62	9.6 ± 0.7	9.5 ± 0.4	0.88
Phosphate (mg/dL)	3.06 ± 0.95	3.1 ± 0.9	2.7 ± 1.3	0.08
PTH (pg/mL)	118 ± 89	117 ± 88	127 ± 96	0.55
Glucose (mg/dL)	99 ± 27	98 ± 24	102 ± 39	0.44
CRP (mg/L)	0.8 (0.3-3)	0.8 (0.3-2.6)	0.8 (0.3-3)	0.78

Data are expressed as mean value and standard deviation, median value and interquartile range or absolute frequency and percentage as appropriate. Group A: Without MACE; Group B: With MACE. MACE: Major advance cardiac event; RTRs: Renal transplant recipients; BP: Blood pressure; eGFR: Estimated glomerular filtration rate; MDRD: Modification of diet in renal disease; LDL: Low density lipoprotein; PTH: Parathyroid hormone.

Table 2 Immunosuppression and cardiovascular disease therapy in all renal transplant recipients and differences between the two groups

	Total RTRs	Group A	Group B	P
Steroids	199 (95.2)	167 (95)	32 (97)	0.61
Mycophenolate mofetil	207 (99)	175 (99.4)	32 (97)	0.18
Tacrolimus	56 (26.8)	49 (27.8)	7 (21.2)	0.43
Cyclosporine	146 (69.9)	122 (69.3)	24 (72.7)	0.69
Everolimus	6 (2.9)	4 (2.3)	2 (6.1)	0.23
CCB	134 (55.4)	116 (56.3)	18 (50)	0.65
Beta-adrenergic blockers	151 (62.4)	128 (62.1)	23 (63.9)	0.86
ARBs/ACEi	131 (54.1)	117 (56.7)	14 (38.9)	0.35
Diuretics	56 (23.1)	46 (21.8)	10 (27.8)	0.58
Other antihypertensive drugs	53 (21.9)	48 (23.3)	5 (13.9)	0.46
Hypolipidemic drugs	154 (63.6)	134 (65)	20 (55.6)	0.49

Immunosuppression therapy was recorded for 209 RTRs. Cardiovascular disease therapy was recorded in all 242 RTRs. Data are expressed as absolute frequency and percentage. Hypolypidemic drugs included statins, fibrates, ezetimibe or combinations of the aforementioned. Group A: With MACE; Group B: Without MACE. MACE: Major advance cardiac event; CCB: Calcium channel blockers; ARBs: Angiotensin receptor blockers; ACEi: Angiotensin converting enzyme inhibitors; RTRs: Renal transplant recipients.

Table 3 Univariate and multivariate analysis of risk factors for major advance cardiac event in renal transplant recipients

Variables (units of increase)	Univariate		Multivariate
	b (95%CI)	P	b (95%CI)	P
MACE risk (1%)	1.04 (1.02-1.06)	< 0.001
Age (1 yr)	1.05 (1.02-1.10)	0.001	1.05 (1.01-1.08)	0.005
Sex (male reference)	0.45 (0.20-0.99)	0.05	0.58 (0.28-1.37)	0.18
Previous smoker	1.51 (0.73-2.92)	0.21
Current smoker	1.0 (0.44-2.29)	0.99
Systolic BP (1 mmHg)	1.01 (0.99-1.02)	0.61
DM	1.53 (0.78-2.98)	0.21
Previous CVD	3.63 (1.88-7.01)	< 0.001	2.86 (1.45-5.62)	0.006
Number of grafts (first graft reference)	0.50 (0.12-2.02)	0.33
Tοtal time on dialysis and transplantation (1 yr)	0.99 (0.92-1.01)	0.33
Creatinine (1 mg/dL)	0.90 (0.48-1.68)	0.74
Urine protein (1 mg/24 h)	0.99 (0.99-1.00)	0.28
Total cholesterol	0.99 (0.99-1.00)	0.3
(1 mg/dL)
LDL (1 mg/dL)	0.99 (0.98-1.01)	0.46
Hemoglobin (1 g/dL)	1.14 (0.93-1.40)	0.21
PTH (1 pg/mL)	1.00 (0.99-1.00)	0.25
CRP (1 mg/L)	1.01 (0.92-1.09)	0.88

MACE: Major advance cardiac event; BP: Blood pressure; DM: Diabetes mellitus; CVD: Cardiovascular disease; LDL: Low density lipoprotein; PTH: Parathyroid hormone; CRP: C-reactive protein.