Acute MI Trends in Renal Transplant Recipients

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Nearly 30% of renal transplant recipient admissions also had STEMI.
Nearly 30% of renal transplant recipient admissions also had STEMI.

HealthDay News – Renal transplant recipients are often admitted with acute myocardial infarction (AMI), according to a study published in The American Journal of Cardiology.

Sahil Agrawal, MD, from St. Luke's University Health Network in Bethlehem, Pennsylvania, and colleagues examined recent trends in AMI admissions for 9243 renal transplant recipients with functioning grafts. Data were compared with those of 160,932 patients with end-stage renal disease without transplantation (ESRD-NRT) and 5,640,851 patients without advanced kidney disease (non-ESRD/RT) admitted with AMI.

The researchers found that 0.2% of AMI admissions were renal transplant recipients, with increasing numbers during the study period (adjusted odds ratio [aOR], 1.04; 95% CI, 1.04-1.05; Ptrend <.001). Acute ST-segment elevation myocardial infarction (STEMI) accounted for 29.3% of renal transplant recipient admissions. History of renal transplantation correlated with decreased likelihood of STEMI at presentation compared with non-ESRD/RT (aOR, 0.73; 95% CI, 0.65-0.80; P <.001).

From 2003 to 2011 there was a decrease in in-hospital mortality among renal transplant recipients admitted for NSTEMI (3.8%-2.1%; aOR, 0.85; 95% CI, 0.78-0.93; P <.001), while no change was seen for STEMI (7.6%-9.3%; aOR, 0.97; 95% CI, 0.90-1.03; P =.36). Compared with ESRD-NRT, the rates of percutaneous coronary interventions and in-hospital mortality were lower for renal transplant recipients (both P <.001).

"Renal transplant recipients were frequently admitted with AMI, particularly NSTEMI," the authors wrote.

Reference

Agrawal S, Garg L, Garg A, et al. Recent trends in management and in-hospital outcomes of acute myocardial infarction in renal transplant recipients. Am J Cardiol. 2017;119(4):542-552. doi: 10.1016/j.amjcard.2016.10.041

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