Factors in cardiac risk stratification of candidates for renal transplant

Background Renal transplant candidates are at high risk of fatal and nonfat al cardiac events. Methods This study evaluated five clinical risk factors - age at least 50 y ears, insulin-requiring diabetes mellitus, angina, congestive heart failure and an abnormal electrocardiogram (ECG) (excluding left ventricular hypert rophy) - that had been used in the first tier of a two-tiered prospectively applied risk stratification algorithm. Results Using multiple logistic regression analysis, age at least 50 years, abnormal EGG, and diabetes mellitus were independently predictive of cardi ac death, Of the two remaining clinical risk factors, the presence of angin a had independent predictive value for nonfatal cardiac events (myocardial infarction, coronary angioplasty, bypass surgery, and unstable angina). The independent predictive value of congestive heart failure approached statis tical significance. Conclusion Clinical risk-factor analysis is helpful in identifying renal tr ansplant candidates at high risk for fatal or nonfatal cardiac events. (C) 1999 Lippincott Williams & Wilkins.