Among 354 kidney transplant recipients, 67 patients (18.9%) experienced major adverse cardiovascular events (MACE), but abnormal pretransplant stress echocardiography was not significantly associated with these outcomes.
Cohort (n=354)
No
Does a positive pretransplant stress echocardiogram predict posttransplant major adverse cardiovascular events in kidney transplant recipients?
Pretransplant stress echocardiography findings were not independently associated with posttransplant major adverse cardiovascular events in kidney transplant recipients, questioning its routine prognostic utility.
Background:Cardiovascular disease remains the leading cause of morbidity and mortality in kidney transplant (KT) recipients.Stress echocardiography (STE) is frequently used in pretransplant risk stratification, but its prognostic value in predicting posttransplant outcomes is uncertain.This retrospective study from a single center aimed to evaluate pretransplant STE findings in 354 KT recipients and their association with posttransplant major adverse cardiovascular events (MACE). Material/Methods:We included KT recipients from our Midwest academic institution between January 2015 and January 2024 who underwent pretransplant STE.STEs were classified as positive (ischemic EKG changes or new wall motion abnormalities) or negative.MACE was defined as cardiovascular death, acute coronary syndrome, heart failure hospitalization, fatal arrhythmia, or stroke.Kaplan-Meier survival curves and Cox regression models were constructed to assess the associations between STE parameters and outcomes. Results:Among 354 KT recipients, 58 (16.3%) had a positive STE.Over a mean follow-up of 5419 months, 67 patients (18.9%) experienced MACE.In unadjusted analyses, age, diabetes, and coronary artery disease were associated with higher MACE risk; however, positive STE was not significantly associated with outcomes.In multivariable models, abnormal STE remained unassociated with MACE or the composite outcome.Kaplan-Meier survival analysis confirmed no difference in MACE-free survival between groups. Conclusions:In this contemporary single-center cohort of KT recipients, abnormal pretransplant STE was not independently associated with posttransplant cardiovascular events.These findings suggest the need to re-evaluate the role of traditional stress testing targeted toward detecting myocardial ischemia in pre-KT evaluation.
Hobbs et al. (Wed,) conducted a cohort in Kidney Transplant (n=354). Stress Echocardiography vs. No Positive Stress Echocardiography was evaluated on Major Adverse Cardiovascular Events (MACE). Among 354 kidney transplant recipients, 67 patients (18.9%) experienced major adverse cardiovascular events (MACE), but abnormal pretransplant stress echocardiography was not significantly associated with these outcomes.