Cardiovascular risk, cardiovascular events, and metabolic syndrome in renal transplantation: comparison of early steroid withdrawal and chronic steroids
Article first published online: 8 NOV 2007
© 2007 Blackwell Munksgaard
Volume 22, Issue 2, pages 229–235, March/April 2008
How to Cite
Rike, A. H., Mogilishetty, G., Alloway, R. R., Succop, P., Roy-Chaudhury, P., Cardi, M., Kaiser, T. E., Thomas, M. and Woodle, E. S. (2008), Cardiovascular risk, cardiovascular events, and metabolic syndrome in renal transplantation: comparison of early steroid withdrawal and chronic steroids. Clinical Transplantation, 22: 229–235. doi: 10.1111/j.1399-0012.2007.00779.x
- Issue published online: 8 NOV 2007
- Article first published online: 8 NOV 2007
- Accepted for publication 4 October 2007
- corticosteroid withdrawal;
- kidney transplant;
Abstract: Background: Cardiovascular disease (CVD) is the leading cause of death with a functioning graft in renal transplant recipients. The purpose of this study was to compare Framingham Risk Score (FRS), metabolic syndrome (MS), and cardiovascular events (CVE) in patients receiving early corticosteroid withdrawal (ECSWD), or chronic corticosteroid therapy (CCS).
Methods: In all, 251 ECSWD and 146 CCS patients were evaluated. FRS and MS were identified at baseline, six, 12, and 24 months post-transplant. A total of 124 patients with diabetes mellitus prior to transplantation were excluded from MS analysis. CVE were defined as sudden-death, MI, angina, or CVA/TIA. Repeat-measure logistic regression was used for statistical analysis.
Results: Fifty-four patients experienced 72 CVE. Mean follow-up was 755 ± 312 d and time to CVE was 14.8 ± 8.3 months. Demographics were similar between groups. FRS was not different between groups. CVE were significantly greater in CCS patients then ECSWD (20% vs. 10%, p = 0.024). New-onset MS occurred more frequently in patients receiving CCS then ECSWD (45% vs. 22%, p < 0.001) and was associated with more CVE (p < 0.015).
Conclusions: Patients receiving ECSWD regimens have significantly decreased CVE and new onset MS compared with CCS. MS is associated with increased CV risk and CVE.