Open AccessMetabolic syndrome in heart transplantation: impact on survival and renal function
Author(s) -
MartínezDolz Luis,
SánchezLázaro Ignacio J.,
AlmenarBonet Luis,
Portolés Manuel,
Rivera Miguel,
Salvador Antonio,
Montero Jose Anastasio
Publication year - 2013
Publication title -
transplant international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.998
H-Index - 82
eISSN - 1432-2277
pISSN - 0934-0874
DOI - 10.1111/tri.12149
Subject(s) - medicine , renal function , odds ratio , creatinine , heart transplantation , transplantation , nephrology , kidney disease , metabolic syndrome , cardiology , heart failure , multivariate analysis , gastroenterology , obesity
Summary The aim of our study was to analyze the early presence of metabolic syndrome ( MS ) in heart transplant ( HT x) patients, and to assess its long‐term impact on survival and renal function. From January 2000 to October 2011, 253 consecutive HT x patients who survived more than 90 days were included. MS was diagnosed if patients met revised NCEP ‐ ATP III criteria at HT x or within 3 months post‐ HT x. The prevalence of MS was 41.9%. Patients with MS had greater overall mortality after a mean follow‐up of 1700 ± 979 days (log‐rank test, P = 0.020). In the multivariate analysis, and subject to a minimum survival of 90 days, the only independent predictor variables of long‐term mortality were the presence of MS ( OR , odds ratio 2.087, P = 0.032), and rejection episodes ( OR 1.833, P = 0.001). Patients with MS had worse renal function at baseline both in plasma creatinine (1.19 ± 0.44 vs. 1.03 ± 0.29 mg/dl, P = 0.002) and glomerular filtration rate estimated by modified diet in renal disease (73.60 ± 26.76 vs. 87.30 ± 43.55 ml/min/1.73m 2 , P = 0.005), whereas progressive impairment of renal function was of equal magnitude in both groups. The presence of MS prior to transplant or its development within the first 3 months identified a subgroup at greater risk of mortality and long‐term renal dysfunction.