PMID- 31006008
OWN - NLM
STAT- MEDLINE
DCOM- 20200917
LR  - 20200917
IS  - 1460-2385 (Electronic)
IS  - 0931-0509 (Linking)
VI  - 35
IP  - 3
DP  - 2020 Mar 1
TI  - Impact of pretransplant mitral annular calcification on the incidence of cardiac 
      events after renal transplantation.
PG  - 526-533
LID - 10.1093/ndt/gfz063 [doi]
AB  - BACKGROUND: Mitral annular calcification (MAC) is associated with increased risk 
      of major adverse cardiac events. We hypothesized that MAC, identified on a 
      pretransplant transthoracic echocardiography (TTE), is predictive of cardiac 
      events following renal transplantation (RT). METHODS: In a retrospective cohort 
      of consecutive RT recipients, pretransplant MAC presence and severity were 
      determined on TTE performed within 1 year prior to transplant. MAC severity was 
      quantified based on the circumferential MAC extension relative to the mitral 
      valve annulus. Post-transplant cardiac risk was assessed using the sum of risk 
      factors (range: 0-8) set forth by the American Heart Association/American College 
      of Cardiology Foundation consensus statement on the assessment of RT candidates. 
      Subjects underwent pretransplant stress single-photon emission computed 
      tomography myocardial perfusion imaging and followed for post-transplant 
      composite outcome of cardiac death or myocardial infarction (CD/MI). RESULTS: 
      Among 336 subjects (60.5% men; mean age 52 +/- 12 years), MAC was present in 78 
      (23%) patients. During a mean follow-up of 3.1 +/- 1.9 years, a total of 70 events 
      were observed. Patients with MAC had a higher event rate compared with those 
      without MAC (34.6% versus 17.8%, log-rank P = 0.001). There was a stepwise 
      increase in CD/MI risk with increasing MAC severity (P for trend = 0.002). 
      MAC-associated risk remained significant after adjusting for sex, duration of 
      dialysis, sum of risk factors, ejection fraction and perfusion abnormality 
      burden, providing an incremental prognostic value to these parameters (Deltachi2 =4.63; 
      P = 0.031). CONCLUSION: Among RT recipients, the burden of pretransplant MAC is 
      an independent predictor of post-transplant risk of CD/MI. MAC should be 
      considered in the preoperative assessment of RT candidates.
CI  - (c) The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. 
      All rights reserved.
FAU - El Hangouche, Nadia
AU  - El Hangouche N
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
FAU - Gomez, Javier
AU  - Gomez J
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
FAU - Asfaw, Addis
AU  - Asfaw A
AD  - Division of Cardiology, University of Tennessee Health Science Center, Memphis, 
      TN, USA.
FAU - Sreenivasan, Jayakumar
AU  - Sreenivasan J
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
FAU - Akhtar, Tauseef
AU  - Akhtar T
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
FAU - Teshome, Meron
AU  - Teshome M
AD  - Division of Cardiology, University of Tennessee Health Science Center, Memphis, 
      TN, USA.
FAU - Vij, Aviral
AU  - Vij A
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
FAU - Matar, Ralph
AU  - Matar R
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
FAU - Campagnoli, Tania
AU  - Campagnoli T
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
FAU - Doukky, Rami
AU  - Doukky R
AD  - Division of Cardiology, Cook County Health, Chicago, IL, USA.
AD  - Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Nephrol Dial Transplant
JT  - Nephrology, dialysis, transplantation : official publication of the European 
      Dialysis and Transplant Association - European Renal Association
JID - 8706402
SB  - IM
MH  - Calcinosis/*complications
MH  - Echocardiography
MH  - Female
MH  - Heart Valve Diseases/*epidemiology/etiology
MH  - Humans
MH  - Incidence
MH  - Kidney Transplantation/*adverse effects
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve/*pathology
MH  - Myocardial Infarction/*epidemiology/etiology
MH  - Prognosis
MH  - Retrospective Studies
MH  - Risk Factors
MH  - United States/epidemiology
OTO - NOTNLM
OT  - chronic kidney disease
OT  - coronary artery disease
OT  - kidney transplant
OT  - mitral annular calcification
OT  - outcome
OT  - pretransplant assessment
EDAT- 2019/04/22 06:00
MHDA- 2020/09/18 06:00
CRDT- 2019/04/22 06:00
PHST- 2018/10/14 00:00 [received]
PHST- 2019/03/10 00:00 [accepted]
PHST- 2019/04/22 06:00 [pubmed]
PHST- 2020/09/18 06:00 [medline]
PHST- 2019/04/22 06:00 [entrez]
AID - 5475753 [pii]
AID - 10.1093/ndt/gfz063 [doi]
PST - ppublish
SO  - Nephrol Dial Transplant. 2020 Mar 1;35(3):526-533. doi: 10.1093/ndt/gfz063.