Coronary artery disease is the main cause of death in patients with functioning renal transplant, reaching 30%, with the highest rate at peri transplant stage. At the same time, the incidence of acute myocardial infraction (AMI) after renal transplant ranges from 5% to 11%. This is why asymptomatic candidates are routinely screened for CAD before transplant.
The aim of this meta-analysis was to compare the effectiveness of coronary revascularization vs optimal medical treatment before transplant.
Primary end point was all cause mortality.
8 studies were looked at, including 945 patients in total. 35.9% were women, mean age 56. Five studies reported total mortality.
There were no significant differences (RR 1.16 [95% CI, 0.63-2.12] in primary end point. Four studies reported cardiovascular mortality, also with no significant differences. (RR, 0.75 [95% CI, 0.29–1.89]).
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Finally , 6 studies reported major cardiovascular events with the same result (RR,0.78 [95% CI, 0.30–2.07]).
Conclusion
This meta-analysis showed coronary revascularization is not superior to optimal medical treatment when it comes to reducing total mortality, cardiovascular mortality, and cardiovascular events in renal transplant candidates.
Dr. Andrés Rodríguez
Member of the Editorial Board of SOLACI.org
Reference: Muhammad U. Siddiqui, J Am Heart Assoc. 2022; 11:e023548.
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