A Retrospective Cohort Study on the Effects of Prekidney Transplant Revascularization on Posttransplant Cardiac Outcomes in Patients With Obstructive Coronary Artery Disease

Background This study compares the incidence of posttransplant major adverse cardiovascular events (MACE) between patients with and without prekidney transplant (KT) revascularization. Methods A retrospective cohort of 518 patients who underwent KT was divided into groups based on whether they underwent pre‐KT revascularization. The primary outcome, MACE, was defined as a composite endpoint including cardiovascular death, nonfatal MI, stroke, need for revascularization, and hospitalization for heart failure. All patients with obstructive CAD received pre‐KT revascularization. Cox proportional hazards models were used to estimate the risk for MACE over a period capped at 5 years in the cohort using the propensity score method of stabilized inverse probability of treatment weighting (IPTW) to address confounders (diabetes status, age, gender, and a past medical history of CAD). Kaplan–Meier curve was constructed to visualize the development of MACE over time (Figure 1). Results Median age of the entire cohort was 56.0 (44, 63) years, 56.9% men, 46.9% White, and 47.6% African Americans. Mean follow‐up was 41.3 ± 29.7 months. Multivariate analysis showed that obtaining pretransplant revascularization was not significantly associated with MACE (hazard ratio [HR] = 0.98, 95% confidence interval 0.45–2.13, p = 0.96). Conclusion This study found that patients with obstructive CAD undergoing revascularization prior to KT had a similar risk of developing MACE compared to patients without obstructive CAD.