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[MP612] PRETRANSPLANT CARDIAC INVESTIGATIONS IN THE IRANIAN RENAL TRANSPLANT POPULATION; FINDING EFFECTIVE SCREENING TECHNIQUES IN PREDICTING CARDIAC EVENTS Afsoon Fazelzadeh, Alireza Mehdizadeh, Ghanbar Ali Rais-Jalali, Mohammad Ali Ostovan. Southern Iran Transplant Center, Nemazee Hospital, Shiraz, Fars, Iran; Cardiology, Nemazee Hospital, Shiraz, Fars, Iran. INTRODUCTION AND AIMS: Cardiovascular disease is the leading cause of death following renal transplantation. While renal transplantation is the treatment of choice for end-stage renal disease, understanding the causes of graft and patient loss and finding some effective cardiovascular screening techniques is exceedingly important to improve outcomes. METHODS: This observational study included 1200 patients who underwent a kidney transplant between 1988 and 2003 in Southern Iran Transplant Center.Any clinical cardiovascular disease, death and all preoperative cardiac screening data was recorded for each patient. The prevalence of various contributing risk factors of cardiovascular diseases has been determined and some methods for early detection, careful monitoring, and persistent follow-up of proven risk factors of cardiovascular disease have been introduced. RESULTS: Among 1200 patients; male/female ratio was 2.1 (808 male, 392 female); mean age was 33.612.5 years (4.5-68). Of all 215 deaths, 28.3% were caused by complications of CAD. Diabetes (p= 0.005), prior transplant (p=0.047), body mass index (BMI) at the time of transplant (p=0.01), cholesterol level (p=0.012) and LDL (p=0.007) during 3 years after transplant were associated with early ACS.Ther was a association of body mass index (BMI) at the time of Tx with cholesterol level(p=0.012) and LDL (p=0.007) during 3 years after Tx. Also there were significant statistical relationship between BMI at the time of Tx and mortality rate during 3 years after Tx. (p=0.01) and renal Tx in obese patients was associated with diminished shortterm and long-term graft survival. (p=0.008). Post transplant diabetes mellitus (PTDM) occurred in 18.8% of our patients and the mean duration of onset of PTDM was 96 days(34-345). Cardiovascular complications happened more frequency in PTDM patients (p=0.01). The mortality of recipients with PTDM was more than non diabetic recipients (p=0.005) and the most common cause of death in this group was cardiovascular disease.63.5% of transplant recipients had unsatisfactory blood pressure control and 8.5% of these had new-onset post transplant hypertension. age at transplant [ Hazard Ratio(HR) 1.91, P<0.001], history of heart failure (HR 8.22, P<0.001), presence of CAD on coronary angiography (HR 5.55, p=0.033), anterior Q wave on electrocardiograph (ECG) (HR 8.6, P<0.001) were significantly associated with reaching a study endpoint. CONCLUSIONS: The high incidence of CVD following renal transplantation is mainly due to a high prevalence and accumulation of classical risk factors before and after transplant. Strategies for early detection and treatment of them can reduce the cardiovascular mortality and morbidity in this high risk population. Monday, July 17, 2006 Poster: Transplantation outcomes

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