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Coronary events in obese hemodialysis patients before and after renal transplantation
Author(s) -
De Lima Jose Jayme G.,
Gowdak Luis Henrique W.,
Paula Flavio J.,
Muela Henrique Cotchi S.,
DavidNeto Elias,
Bortolotto Luiz A.
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12616
Subject(s) - medicine , dyslipidemia , myocardial infarction , hemodialysis , cardiology , angina , transplantation , diabetes mellitus , unstable angina , coronary artery disease , obesity , endocrinology
Abstract We examined the impact of obesity ( BMI ≥30 kg/m 2 , n = 357) on prognosis in 1696 hemodialysis ( HD ) patients before and after renal transplantation ( TX ). End‐points were coronary events, composite cardiovascular ( CV ) events, and death. Obese HD patients were older (55.9 ± 9.2 vs. 54.2 ± 11), had more diabetes (54% vs. 40%), dyslipidemia (49% vs. 30%), altered myocardial scan (38% vs. 31%), myocardial infarction ( MI ) (16% vs. 10%), coronary intervention (11% vs. 7%), higher total cholesterol (186 ± 52 vs. 169 ± 47), and triglycerides (219 ± 167 vs. 144 ± 91). Obese undergoing TX had more dyslipidemia (46% vs. 31%), angina (23% vs. 14%), MI (18% vs. 5%), increased total cholesterol (185 ± 56 vs. 172 ± 48), and triglycerides (237 ± 190 vs. 149 ± 100). Obesity was independently associated with coronary events (log‐rank = 0.008, HR 2.55% CI 1.27–5.11) and death (log‐rank 0.046, HR 1.52, % CI 1.007–2.30) in TX but not in HD . Obese HD patients had more risk factors and ischemic heart disease, but these characteristics did not interfere with prognosis. In TX patients, obesity predicts coronary events and death.