Trends in coronary artery disease screening before kidney transplantation

Author:

Cheng Xingxing S.ORCID,Liu Sai,Han JialinORCID,Stedman Margaret R.ORCID,Chertow Glenn M.ORCID,Tan Jane C.,Fearon William F.

Abstract

Background: Coronary artery disease (CAD) screening in asymptomatic kidney transplant candidates is widespread but not well supported by contemporary cardiology literature. We describe here temporal trends in CAD screening before kidney transplant in the United States. Methods: Using the United States Renal Data System, we examined Medicare-insured adults who received a first kidney transplant from 2000 through 2015. We stratified analysis based on whether the patient's comorbidity burden met guideline definitions of high-risk for CAD. We examined temporal trends in non-urgent CAD tests within the year prior to transplant and the composite of death and non-fatal myocardial infarction in the 30 days after transplant. Results: Of 94,832 kidney transplant recipients, 37,139 (39%) underwent at least one non-urgent CAD test in the 1 year prior to transplant. From 2000 to 2015, The transplant program waitlist volume had increased as transplant volume stayed constant, while patients in the later eras had slightly higher comorbidity burden (older, longer dialysis vintage, and a higher prevalence of diabetes mellitus and CAD). The likelihood of CAD test in the year prior to transplant increased from 2000 through 2003 and remained relatively stable thereafter. When stratified by CAD risk status, test rates decreased modestly in high-risk patients but remained constant in low-risk patients after 2008. Death or non-fatal myocardial infarction within 30 days after transplant decreased from 3.4% in 2000 to 1.5% in 2015. Nuclear perfusion scan was the most frequent modality of testing throughout examined time periods. Conclusions: CAD testing rates before kidney transplantation have remained constant from 2000 through 2015 despite widespread changes in cardiology guidelines and practice.

Funder

American Heart Association

HHS | NIH | National Institute of Diabetes and Digestive and Kidney Diseases

Sobrato Gift Fund

Publisher

American Society of Nephrology (ASN)

Subject

General Medicine

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3