The burden of coronary heart disease in simultaneous pancreas-kidney transplantation

Detalhes bibliográficos
Autor(a) principal: Marques, Joana
Data de Publicação: 2022
Outros Autores: Pereira, Luísa, Messias, Ana, Fonseca, Nuno, Cotovio, Patrícia, Ferreira, Aníbal, Nolasco, Fernando
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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spelling 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
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dc.language.iso.fl_str_mv eng
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dc.relation.none.fl_str_mv 0101-2800
PURE: 42283959
https://doi.org/10.1590/2175-8239-JBN-2021-0156
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instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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