The burden of coronary heart disease in simultaneous pancreas-kidney transplantation
Autor(a) principal: | |
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Data de Publicação: | 2022 |
Outros Autores: | , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
Texto Completo: | http://hdl.handle.net/10362/134766 |
Resumo: | INTRODUCTION: Type 1 diabetes mellitus is associated with an increased risk of coronary artery disease, which is frequently asymptomatic. This risk increases significantly in those with nephropathy. In selected patients, simultaneous pancreas-kidney transplantation is the renal and pancreatic replacement therapy of choice, as it increases longevity and stabilizes diabetic complications. Despite essential, universal screening protocols are still controversial for coronary artery disease in this population. METHODS: We retrospectively analysed 99 simultaneous pancreas-kidney recipients from our centre from 2011 to 2018 and selected 77 patients who underwent coronary angiography during the pre-transplant evaluation. Our aim was to identify potential risk factors associated with significant lesions on coronary angiography. RESULTS: Almost half of our cohort of 77 candidates submitted to coronary angiography had coronary artery disease. Of these, nearly 30% underwent revascularization, although only one of them reported symptoms of myocardial ischemia. In a univariate analysis, the presence of smoking habits was the only risk factor for coronary artery disease. We also found that 20 or more years of type 1 diabetes mellitus was significantly associated with the presence of coronaropathy. DISCUSSION: Selection of diabetic candidates with acceptable cardiac risk before simultaneous pancreas-kidney transplantation is imperative. Given the impact of a correct diagnosis and a low procedural risk, we defend the routine use of coronary angiography as the initial screening method for coronary artery disease in this population. Particularly care must be taken in evaluating asymptomatic patients with long-term type 1 diabetes mellitus and smokers. |
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The burden of coronary heart disease in simultaneous pancreas-kidney transplantationcoronary angiography as a diagnostic method for all? - a retrospective studyDiabetes MellitusType 1Kidney FailureChronicSimultaneous Pancreas-Kidney TransplantationCoronary Artery DiseaseCoronary AngiographySDG 3 - Good Health and Well-beingINTRODUCTION: Type 1 diabetes mellitus is associated with an increased risk of coronary artery disease, which is frequently asymptomatic. This risk increases significantly in those with nephropathy. In selected patients, simultaneous pancreas-kidney transplantation is the renal and pancreatic replacement therapy of choice, as it increases longevity and stabilizes diabetic complications. Despite essential, universal screening protocols are still controversial for coronary artery disease in this population. METHODS: We retrospectively analysed 99 simultaneous pancreas-kidney recipients from our centre from 2011 to 2018 and selected 77 patients who underwent coronary angiography during the pre-transplant evaluation. Our aim was to identify potential risk factors associated with significant lesions on coronary angiography. RESULTS: Almost half of our cohort of 77 candidates submitted to coronary angiography had coronary artery disease. Of these, nearly 30% underwent revascularization, although only one of them reported symptoms of myocardial ischemia. In a univariate analysis, the presence of smoking habits was the only risk factor for coronary artery disease. We also found that 20 or more years of type 1 diabetes mellitus was significantly associated with the presence of coronaropathy. DISCUSSION: Selection of diabetic candidates with acceptable cardiac risk before simultaneous pancreas-kidney transplantation is imperative. Given the impact of a correct diagnosis and a low procedural risk, we defend the routine use of coronary angiography as the initial screening method for coronary artery disease in this population. Particularly care must be taken in evaluating asymptomatic patients with long-term type 1 diabetes mellitus and smokers.NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM)RUNMarques, JoanaPereira, LuísaMessias, AnaFonseca, NunoCotovio, PatríciaFerreira, AníbalNolasco, Fernando2022-03-17T23:23:17Z2022-102022-10-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10362/134766eng0101-2800PURE: 42283959https://doi.org/10.1590/2175-8239-JBN-2021-0156info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-03-11T05:13:13Zoai:run.unl.pt:10362/134766Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T03:48:13.793925Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse |
dc.title.none.fl_str_mv |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation coronary angiography as a diagnostic method for all? - a retrospective study |
title |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation |
spellingShingle |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation Marques, Joana Diabetes Mellitus Type 1 Kidney Failure Chronic Simultaneous Pancreas-Kidney Transplantation Coronary Artery Disease Coronary Angiography SDG 3 - Good Health and Well-being |
title_short |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation |
title_full |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation |
title_fullStr |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation |
title_full_unstemmed |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation |
title_sort |
The burden of coronary heart disease in simultaneous pancreas-kidney transplantation |
author |
Marques, Joana |
author_facet |
Marques, Joana Pereira, Luísa Messias, Ana Fonseca, Nuno Cotovio, Patrícia Ferreira, Aníbal Nolasco, Fernando |
author_role |
author |
author2 |
Pereira, Luísa Messias, Ana Fonseca, Nuno Cotovio, Patrícia Ferreira, Aníbal Nolasco, Fernando |
author2_role |
author author author author author author |
dc.contributor.none.fl_str_mv |
NOVA Medical School|Faculdade de Ciências Médicas (NMS|FCM) RUN |
dc.contributor.author.fl_str_mv |
Marques, Joana Pereira, Luísa Messias, Ana Fonseca, Nuno Cotovio, Patrícia Ferreira, Aníbal Nolasco, Fernando |
dc.subject.por.fl_str_mv |
Diabetes Mellitus Type 1 Kidney Failure Chronic Simultaneous Pancreas-Kidney Transplantation Coronary Artery Disease Coronary Angiography SDG 3 - Good Health and Well-being |
topic |
Diabetes Mellitus Type 1 Kidney Failure Chronic Simultaneous Pancreas-Kidney Transplantation Coronary Artery Disease Coronary Angiography SDG 3 - Good Health and Well-being |
description |
INTRODUCTION: Type 1 diabetes mellitus is associated with an increased risk of coronary artery disease, which is frequently asymptomatic. This risk increases significantly in those with nephropathy. In selected patients, simultaneous pancreas-kidney transplantation is the renal and pancreatic replacement therapy of choice, as it increases longevity and stabilizes diabetic complications. Despite essential, universal screening protocols are still controversial for coronary artery disease in this population. METHODS: We retrospectively analysed 99 simultaneous pancreas-kidney recipients from our centre from 2011 to 2018 and selected 77 patients who underwent coronary angiography during the pre-transplant evaluation. Our aim was to identify potential risk factors associated with significant lesions on coronary angiography. RESULTS: Almost half of our cohort of 77 candidates submitted to coronary angiography had coronary artery disease. Of these, nearly 30% underwent revascularization, although only one of them reported symptoms of myocardial ischemia. In a univariate analysis, the presence of smoking habits was the only risk factor for coronary artery disease. We also found that 20 or more years of type 1 diabetes mellitus was significantly associated with the presence of coronaropathy. DISCUSSION: Selection of diabetic candidates with acceptable cardiac risk before simultaneous pancreas-kidney transplantation is imperative. Given the impact of a correct diagnosis and a low procedural risk, we defend the routine use of coronary angiography as the initial screening method for coronary artery disease in this population. Particularly care must be taken in evaluating asymptomatic patients with long-term type 1 diabetes mellitus and smokers. |
publishDate |
2022 |
dc.date.none.fl_str_mv |
2022-03-17T23:23:17Z 2022-10 2022-10-01T00:00:00Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://hdl.handle.net/10362/134766 |
url |
http://hdl.handle.net/10362/134766 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
0101-2800 PURE: 42283959 https://doi.org/10.1590/2175-8239-JBN-2021-0156 |
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info:eu-repo/semantics/openAccess |
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openAccess |
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application/pdf |
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RCAAP |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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