Key result
Removing an infected renal allograft prevents repeat ACS over 12 months in a single patient.
Why the study?
Although persistent systemic inflammation predicts future cardiovascular events, it remains unclear whether C-reactive protein plays an active role in coronary-plaque instability.
Does removal of a failed, super-infected renal allograft reduce systemic inflammation and prevent recurrent acute coronary syndromes in a patient with type-2 diabetes?
Case Report (n=1)
Does removal of a failed, super-infected renal allograft reduce systemic inflammation and prevent recurrent acute coronary syndromes in a patient with type-2 diabetes?
This case report suggests that severe systemic inflammation from a failed renal allograft may drive coronary plaque instability and recurrent acute coronary syndromes, which can be mitigated by removing the source of inflammation.
Background: Although persistent systemic inflammation is considered to be predictive for future cardiovascular events, it remains unclear whether or not C-reactive protein (CrP) plays an active role in coronary-plaque instability. Here, we report a case of a patient with failed and super-infected renal allograft as a source for systemic inflammation presenting with repeat acute coronary syndromes. Case presentation: A 52-years-old male type-2 diabetic with a failed kidney transplant who was hospitalized for acute urinary-tract infection. In the presence of other, classic cardiovascular risk factors, peak values of CrP coincided with episodes of unstable angina treated by percutaneous coronary interventions. Besides pyelonephritis, the histological examination of the kidney transplant revealed signs of chronic rejection and the presence of a renal cell carcinoma in situ. Once the renal allograft has been removed, systemic inflammation was attenuated, the patient was not re-hospitalized for acute-coronary syndrome within the next 12 months. Conclusion: In this case, systemic inflammation was paralleled by instability of coronary plaques as documented by repeat percutaneous coronary interventions.
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Pliquett et al. (2021) conducted a case report in Renal allograft-related inflammation and acute coronary syndromes (n=1). Removal of renal allograft was evaluated on Repeat acute coronary syndromes. Removal of a failed, super-infected renal allograft attenuated systemic inflammation and prevented re-hospitalization for acute coronary syndrome over the next 12 months in a 52-year-old male.
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