Details

Autor(en) / Beteiligte

• Roccaro, G. A.
• Goldberg, D. S.
• Hwang, W.‐T.
• Judy, R.
• Thomasson, A.
• Kimmel, S. E.
• Forde, K. A.
• Lewis, J. D.
• Yang, Y.‐X.

Titel

Sustained Posttransplantation Diabetes Is Associated With Long‐Term Major Cardiovascular Events Following Liver Transplantation

Ist Teil von

• American journal of transplantation, 2018-01, Vol.18 (1), p.207-215

Ort / Verlag

United States: Wiley Subscription Services, Inc

Erscheinungsjahr

2018

Quelle

MEDLINE

Beschreibungen/Notizen

• Cardiovascular disease is a leading cause of death among liver transplant (LT) recipients. With a rising burden of posttransplantation metabolic disease, increases in cardiovascular‐related morbidity and mortality may reduce life expectancy after LT. It is unknown if the risk of long‐term major cardiovascular events (MCEs) differs among LT recipients with varying diabetic states. We performed a retrospective cohort study of LT recipients from 2003 through 2013 to compare the incidence of MCEs among patients (1) without diabetes, (2) with pretransplantation diabetes, (3) with de novo transient posttransplantation diabetes, and (4) with de novo sustained posttransplantation diabetes. We analyzed 994 eligible patients (39% without diabetes, 24% with pretransplantation diabetes, 16% with transient posttransplantation diabetes, and 20% with sustained posttransplantation diabetes). Median follow‐up was 54.7 months. Overall, 12% of patients experienced a MCE. After adjustment for demographic and clinical variables, sustained posttransplantation diabetes was the only state associated with a significantly increased risk of MCEs (subdistribution hazard ratio 1.95, 95% confidence interval 1.20–3.18). Patients with sustained posttransplantation diabetes mellitus had a 13% and 27% cumulative incidence of MCEs at 5 and 10 years, respectively. While pretransplantation diabetes has traditionally been associated with cardiovascular disease, the long‐term risk of MCEs is greatest in LT recipients with sustained posttransplantation diabetes mellitus. In a retrospective cohort study of 994 liver transplant recipients utilizing adjusted competing risk regression models, sustained posttransplant diabetes mellitus is the only diabetic state associated with a significantly increased risk of long‐term major atherosclerotic cardiac events and cardiac arrest.