Dataset Information

External Validation of Proposed American Heart Association Algorithm for Cardiovascular Screening Before Kidney Transplantation.

ABSTRACT:

Background

Screening for cardiovascular disease is currently recommended before kidney transplantation. The present study aimed to validate the proposed algorithm by the American Heart Association (AHA-2022) considering cardiovascular findings and outcomes in kidney transplant candidates, and to compare AHA-2022 with the previous recommendation (AHA-2012).

Methods and results

We applied the 2 screening algorithms to an observational cohort of kidney transplant candidates (n=529) who were already extensively screened for coronary heart disease by referral to cardiac computed tomography between 2014 and 2019. The cohort was divided into 3 groups as per the AHA-2022 algorithm, or into 2 groups as per AHA-2012. Outcomes were degree of coronary heart disease, revascularization rate following screening, major adverse cardiovascular events, and all-cause death. Using the AHA-2022 algorithm, 69 (13%) patients were recommended for cardiology referral, 315 (60%) for cardiac screening, and 145 (27%) no further screening. More patients were recommended cardiology referral or screening compared with the AHA-2012 (73% versus 53%; P<0.0001). Patients recommended cardiology referral or cardiac screening had a higher risk of major adverse cardiovascular events (hazard ratio [HR], 5.5 [95% CI, 2.8-10.8]; and HR, 2.1 [95% CI, 1.2-3.9]) and all-cause death (HR, 12.0 [95% [CI, 4.6-31.4]; and HR, 5.3 [95% CI, 2.1-13.3]) compared with patients recommended no further screening, and were more often revascularized following initial screening (20% versus 7% versus 0.7%; P<0.001).

Conclusions

The AHA-2022 algorithm allocates more patients for cardiac referral and screening compared with AHA-2012. Furthermore, the AHA-2022 algorithm effectively discriminates between kidney transplant candidates at high, intermediate, and low risk with respect to major adverse cardiovascular events and all-cause death.

SUBMITTER: Nielsen MB

PROVIDER: S-EPMC10863782 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

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Publications

External Validation of Proposed American Heart Association Algorithm for Cardiovascular Screening Before Kidney Transplantation.

Nielsen Marie Bodilsen MB Dahl Jonathan Nørtoft JN Jespersen Bente B Ivarsen Per P Birn Henrik H Winther Simon S

Journal of the American Heart Association 20231212 24

<h4>Background</h4>Screening for cardiovascular disease is currently recommended before kidney transplantation. The present study aimed to validate the proposed algorithm by the American Heart Association (AHA-2022) considering cardiovascular findings and outcomes in kidney transplant candidates, and to compare AHA-2022 with the previous recommendation (AHA-2012).<h4>Methods and results</h4>We applied the 2 screening algorithms to an observational cohort of kidney transplant candidates (n=529) w ...[more]

PMID: 38084711

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Dataset Information

External Validation of Proposed American Heart Association Algorithm for Cardiovascular Screening Before Kidney Transplantation.

Background

Methods and results

Conclusions

Publications

External Validation of Proposed American Heart Association Algorithm for Cardiovascular Screening Before Kidney Transplantation.

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