A NEW RISK-SCORE MODEL TO PREDICT CARDIOVASCULAR EVENTS IN RENAL TRANSPLANT CANDIDATES

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorGOWDAK, Luis Henrique Wolff
dc.contributor.authorPAULA, Flavio J. de
dc.contributor.authorCESAR, Luiz Antonio M.
dc.contributor.authorLIMA, Jose Jayme G. de
dc.date.accessioned2013-10-11T21:17:45Z
dc.date.available2013-10-11T21:17:45Z
dc.date.issued2012
dc.description.abstractBackground Renal transplant candidates (RTC) are at increased risk for cardiovascular events (MACE). We developed a new risk-score model to predict MACE in pt with end-stage renal disease (ESRD). Methods 1,057 RTC (61% men, 53±11 years) were prospectively enrolled. The median follow-up was 16 (1 – 107) months. A logistic regression model was built from three clinically relevant co-variates as defined by the American Society of Transplantation (age, diabetes, and known CVD); the occurrence of the first or new fatal/non-fatal MACE (sudden death, acute myocardial infarction or unstable angina, stroke, peripheral artery disease, or overt heart failure) was regarded as the dependent variable. The logistic regression coefficient B for each variable was multiplied by 10 and rounded to the next whole number, allowing that, for each patient, a correspondent risk-score could be assigned. The receiver-operating-characteristic curve (ROC) was constructed to estimate the accuracy of the new-score. Finally, the prevalence of significant CAD for each risk-score was determined and a linear regression model between risk-score and the probability of MACE was calculated. Results There were 209 events during follow-up. The B coefficients for age, diabetes and CVD were 0.03, 0.62, and 0.89 (all P<.01), respectively. Thus, the risk-score could be calculated by the equation: Risk-Score = (Age * 0.3) + (DM * 6.2) + (CVD * 8.9). The respective area under the curve (ROC) was 0.70 (P=.0001) and the final equation relating the risk-score with the expected probability of the first occurrence of MACE was: Probability of MACE = (Risk-Score *1.45) – 14.2 (R2 = 0.94; P<.0001). As an example, a non-diabetic 40-year old RTC with no evidence of CVD will have an expected probability of suffering a first MACE of 3.2% whereas a 65-year old diabetic pt with peripheral artery disease will have an expected probability of 36.0%. Conclusions We developed and validated a new, simple risk-score to predict the occurrence of the first or new MACE among potential renal transplant recipients. This model should help cardiologists to better identify high-risk RTC, so that a cardiovascular risk reduction program can be aggressively implemented. ACC Moderated Poster Contributions McCormick Place South, Hall A Sunday, March 25, 2012, 11:00 a.m.-Noon Session Title: Prevention Abstract Category: 9. Prevention: Clinical Presentation Number: 1181-155
dc.description.conferencedateMAR 24-27, 2012
dc.description.conferencelocalChicago - IL, EUA
dc.description.conferencename61st Annual Scientific Session and Expo of the American-College-of-Cardiology (ACC)
dc.description.indexMEDLINE
dc.identifier.citationJOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, v.59, n.13, suppl.S, p.E1734-E1734, 2012
dc.identifier.issn0735-1097
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/2813
dc.language.isoeng
dc.publisherELSEVIER SCIENCE INC
dc.relation.ispartofJournal of the American College of Cardiology
dc.rightsrestrictedAccess
dc.rights.holderCopyright ELSEVIER SCIENCE INC
dc.subject.wosCardiac & Cardiovascular Systems
dc.titleA NEW RISK-SCORE MODEL TO PREDICT CARDIOVASCULAR EVENTS IN RENAL TRANSPLANT CANDIDATES
dc.typeconferenceObject
dc.type.categorymeeting abstract
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.contributor.author-fmusphcLUIS HENRIQUE WOLFF GOWDAK
hcfmusp.contributor.author-fmusphcFLAVIO JOTA DE PAULA
hcfmusp.contributor.author-fmusphcLUIZ ANTONIO MACHADO CESAR
hcfmusp.contributor.author-fmusphcJOSE JAYME GALVAO DE LIMA
hcfmusp.description.beginpageE1734
hcfmusp.description.endpageE1734
hcfmusp.description.issue13
hcfmusp.description.issuesuppl S
hcfmusp.description.volume59
hcfmusp.origemWOS
hcfmusp.origem.wosWOS:000302326701845
hcfmusp.publisher.cityNEW YORK
hcfmusp.publisher.countryUSA
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Arquivos
Coleções
Comunicações em Eventos - FM/MCP
Comunicações em Eventos - HC/ICHC
Comunicações em Eventos - HC/InCor
Comunicações em Eventos - LIM/13