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Journal of Transplantation
Volume 2014 (2014), Article ID 854397, 11 pages
http://dx.doi.org/10.1155/2014/854397
Clinical Study

Risk-Stratified Cardiovascular Screening Including Angiographic and Procedural Outcomes of Percutaneous Coronary Interventions in Renal Transplant Candidates

1Department of Cardiology, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
2Department of Nephrology and Intensive Care, Charité Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany
3Division of Emergency Medicine, Charité Campus Virchow-Klinikum and Mitte, Augustenburger Platz 1, 13353 Berlin, Germany
4Department of Cardiology and Angiology, Charité Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany
5Berlin-Brandenburg Center for Regenerative Therapies (BCRT), Charité Campus Virchow-Klinikum, Charite-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany

Received 16 January 2014; Revised 8 May 2014; Accepted 12 May 2014; Published 19 June 2014

Academic Editor: Gaetano Ciancio

Copyright © 2014 Julian König et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Benefits of cardiac screening in kidney transplant candidates (KTC) will be dependent on the availability of effective interventions. We retrospectively evaluated characteristics and outcome of percutaneous coronary interventions (PCI) in KTC selected for revascularization by a cardiac screening approach. Methods. In 267 patients evaluated 2003 to 2006, screening tests performed were reviewed and PCI characteristics correlated with major adverse cardiovascular events (MACE) during a follow-up of 55 months. Results. Stress tests in 154 patients showed ischemia in 28 patients (89% high risk). Of 58 patients with coronary angiography, 38 had significant stenoses and 18 cardiac interventions (6.7% of all). 29 coronary lesions in 17/18 patients were treated by PCI. Angiographic success rate was 93.1%, but procedural success rate was only 86.2%. Long lesions ( ) and diffuse disease ( ) were associated with MACE. In high risk patients, cardiac screening did not improve outcome as 21.7% of patients with versus 15.5% of patients without properly performed cardiac screening had MACE ( ). Conclusion. The moderate procedural success of PCI and poor outcome in long and diffuse coronary lesions underscore the need to define appropriate revascularization strategies in KTC, which will be a prerequisite for cardiac screening to improve outcome in these high-risk patients.