Abstract 16783: Beta-Blockers and ACE Inhibitors Improve Long-Term Survival In Renal Transplant Recipients: Results From 10 Year Follow-Up in 321 Patients
Background: End stage renal disease is associated with a dismal cardiovascular prognosis and is improved to some extent by renal transplantation. Hence, we analyzed the cardiovascular predictors of survival after renal transplantation to gain insights into potential therapeutic targets to improve their outcomes.
Methods: We abstracted the medical records of 321 consecutive patients from our institution who had received renal transplantation between 1995 and 2003. Survival was analyzed as a function of clinical and pharmacological variables.
Results: The characteristics of the 321 patients were as follows: age at transplant 49+13 years, 40% males, HTN in 89%, diabetes mellitus (DM) in 37% and LV EF 58+17%. Over a follow up of 10+4 years, there were 119 deaths. Cox proportional hazard model showed DM (HR 1.5, P= 0.05), prior myocardial infarction (MI) (HR 2.6, P=0.001), perioperative MI (HR 2.6, P=0.002), and lack of beta blocker (BB) therapy (HR 1.6, P=0.06) and ACEI (HR 1.9, p=0.006) to be independent predictors of higher mortality. The 10 year survival in patients receiving BB was 80% vs. 63% for no BB and 82% for those receiving ACEI vs. 62% for no ACEI.
Conclusions: (1) Annualized mortality after renal transplantation is about 3%, being higher in the aged, diabetics and those with prior or perioperative MI. (2) Use of BB and ACEI therapies are associated with a higher survival independent of CAD or DM indicating a potential protective role in this high risk population.
- © 2011 by American Heart Association, Inc.