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Santana JC, Doppalapudi H, Ives CW, et al. Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation. Am J Transplant. 2021;doi: 10.1111/ajt.16938.
Santana, J. C., Doppalapudi, H., Ives, C. W., Farag, A. A., Rizk, D. V., Kumar, V., Iskandrian, A. E., & Hage, F. G. (2021). Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation. American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons, . https://doi.org/10.1111/ajt.16938
Santana, Julio C, et al. "Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation." American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons vol. (2021). doi: https://doi.org/10.1111/ajt.16938
Santana JC, Doppalapudi H, Ives CW, Farag AA, Rizk DV, Kumar V, Iskandrian AE, Hage FG. Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation. Am J Transplant. 2021 Dec 29; doi: 10.1111/ajt.16938. Epub 2021 Dec 29. PMID: 34967107.
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Am J Transplant. 2021 Dec 29; doi: 10.1111/ajt.16938. Epub 2021 Dec 29.

Prognostic value of silent myocardial infarction in patients with chronic kidney disease after kidney transplantation.

American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons

Julio C Santana, Harish Doppalapudi, Christopher W Ives, Ayman A Farag, Dana V Rizk, Vineeta Kumar, Ami E Iskandrian, Fadi G Hage

Affiliations

  1. Internal Medicine Department, University of Miami, Jackson Memorial Hospital, Miami, FL.
  2. Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.
  3. Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL.
  4. Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.

PMID: 34967107 DOI: 10.1111/ajt.16938

Abstract

We have shown that silent myocardial infarction (SMI) on 12-lead ECG is associated with increased Cardiovascular Disease (CVD) risk in patients awaiting renal transplantation (RT). In this study, we evaluated the prevalence of SMI in patients undergoing RT and their prognostic value after RT. MI was determined by automated analysis of ECG. SMI was defined as ECG evidence of MI without a history of clinical MI (CMI). The primary outcome was a composite of CVD death, non-fatal MI and coronary revascularization after RT. Of the 1,189 patients who underwent RT, a 12-lead ECG was available in > 99%. Of the entire cohort 6% had a history of CMI while 7% had SMI by ECG. During a median follow-up of 4.6 years, 147 (12%) experienced the primary outcome (8% CVD death, 4% MI, 4% coronary revascularization) and 12% died. Both SMI and CMI were associated with increased risk of CVD events and all-cause deaths. In a multivariable adjusted Cox-regression model, both SMI (adjusted hazard ratio 2.03, [1.25-3.30], p=0.004) and CMI (2.15 [1.24-3.74], p=0.007) were independently associated with the primary outcome. SMI detected by ECG prior to RT is associated with increased risk of CVD events after RT.

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