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Abstract: SA-PO1067

Long-Term Evaluation of Coronary Calcifications in Kidney-Transplanted Patients: A Single Center Follow-Up of 15 Years

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Alfieri, Carlo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Perna, Alessandro, Universita degli Studi della Campania Luigi Vanvitelli, Caserta, Italy
  • Forzenigo, Laura, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Schiraldi, Giorgia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Regalia, Anna, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Molinari, Paolo, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
  • Castellano, Giuseppe, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Lombardia, Italy
Background

Few data are available on the long term behavior of coronary artery calcifications (CAC) in kidney transplantation (KTx). In a previous paper (Alfieri C et al. Sci Rep. 2019), we evaluated the factors implicated with CAC progression after 5 years of KTx. Here we present the preliminary data about CAC follow-up of the same population after 15 years of KTx (T15).

Methods

Previously 67 KTxps (2007-2008) were studied. At the present time, 19 of them were lost from the follow up: 8 died, 4 because of major cardiovascular event (MACE), 11 had a graft loss and 20 did not adhere to the control. Then, we evaluated 28 KTxps (M=18; age 60±9 yrs). Clinical, blood and urinary data were recorded for 15 years, considering the mean values in the analyses. At baseline and T15, using coronary TC, Agatson score was evaluated and patients were accordingly categorized in 4 groups: 1)0-10; 2)10-100; 3)100-400; 4)>400. The CAC progression was tested using the modification in CAC category (Cat-Prog+T15) and the formula proposed by Sevrukov (Prog+).

Results

At baseline and at T15, 46% and 18 % of pts were in the 1st grp, 14% and 25 % in the 2nd, 29% and 18% in the 3rd and 11 % and 39% in 4th, respectively. CAC at T15 were significantly higher than baseline (156±50 vs 334±71 p<0.0001). Both at baseline and at T15 CAC correlated directly with age and with each other. In the 79% Cat-Prog+T15 was found, in the 10,7% of more than 1 grp of CAC. 71% of KTxps were Prog+. They had higher systolic blood pressure levels, with no difference in specific therapy, lower mean Hb and Ca levels. Mean Ca Levels resulted the only independent factor inversely related with Prog+ (p=0.04). During the 15 years of KTx 25% of KTx had a MACE. No impact for CACs was found in MACE.

Conclusion

To the best of our knowledge, our study is the first one to evaluate CACs in KTxps for such a long time. According to the preliminary data obtained: 1) the prevalence of CAC in KTxps is high, and is related to age; 2) CAC worsening was observed in a consistent part of the cohort and was related to different parameters, especially to Ca levels. Future researches, possibly involving a higher number of KTxps could explain better these findings and explore more deeply the relation of CACs with MACE in the long term.