Acute Myocardial Infarction Common in Renal Transplant Recipients

HealthDay News — Renal transplant recipients (RTRs) are often admitted with acute myocardial infarction (AMI), according to a study published in The American Journal of Cardiology.

Sahil Agrawal, MD, from St. Luke’s University Health Network in Bethlehem, Pennsylvania, and colleagues examined recent trends in AMI admissions for 9243 RTRs with functioning grafts. Data were compared to those of 160,932 patients with end-stage renal disease without transplantation (ESRD-NRT) and 5,640,851 patients without advanced kidney disease (non-ESRD/RT) admitted with AMI.

The researchers found that 0.2% of AMI admissions were RTRs, with increasing numbers during the study period (adjusted odds ratio [aOR], 1.04; 95% CI, 1.04 to 1.05; Ptrend <.001). Acute ST-segment elevation myocardial infarction (STEMI) accounted for 29.3% of RTR admissions. History of renal transplantation correlated with decreased likelihood of STEMI at presentation compared with non-ESRD/RT (aOR, 0.73; 95% CI, 0.65 to 0.80; P <.001). 

From 2003 to 2011 there was a decrease in in-hospital mortality among RTRs admitted for non-STEMI (3.8% to 2.1%; aOR, 0.85; 95% CI, 0.78 to 0.93; P <.001), while no change was seen for STEMI (7.6% to 9.3%; aOR, 0.97; 95% CI, 0.90 to 1.03; P =.36). Compared with ESRD-NRT, the rates of percutaneous coronary interventions and in-hospital mortality were lower for RTRs (both P <.001).

“RTRs were frequently admitted with AMI, particularly NSTEMI,” the authors write.

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Naqvi SY, Klein J, Saha T, McCormick DJ, Goldberg S. Comparison of percutaneous coronary intervention versus coronary artery bypass grafting for unprotected left main coronary artery disease. Am J Cardiol. 2017;119:520-527. doi: 10.1016/j.amjcard.2016.11.003