Key result
Removing an infected renal allograft averts ACS rehospitalization over 12 months in a single case.
Why the study?
Although persistent systemic inflammation predicts 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 acute coronary syndrome in a patient with accelerated coronary artery disease?
Case Report (n=1)
Does removal of a failed, super-infected renal allograft reduce systemic inflammation and prevent acute coronary syndrome in a patient with accelerated coronary artery disease?
This case report suggests that severe systemic inflammation from a failed renal allograft may drive coronary plaque instability, which can be stabilized by removing the source of inflammation.
Hypothesis-generating that failed-allograft inflammation may drive ACS; requires prospective studies before any clinical consideration.
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 cardiologic 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 rehospitalized 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 coronary angiograms.
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Pliquett et al. (2021) conducted a case report in Failed renal allograft and acute coronary syndrome (n=1). Removal of renal allograft was evaluated on Rehospitalization for acute-coronary syndrome. Removal of a failed, super-infected renal allograft attenuated systemic inflammation and prevented rehospitalization for acute coronary syndrome over 12 months in a 52-year-old male.
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