Predictive Role of the INDANA CV Score System in Kidney Transplant Recipients

ackground: Cardiovascular morbidity and mortality are a major cause of complication and death in renal transplantation. It is unclear whether cardiovascular scoring systems validated in the general population could be predictive of Major Acute Cardiovascular Events (MACE) also in renal transplant recipients (KTx). Aim of this study was to evaluate the Framingham and the INDANA score systems as predictors of MACE in KTx Patients & Methods: Our study population included 425 consecutive KTx who underwent kidney transplantation between 1997 – 2007 at a single renal transplant unit. During the follow up period all the MACE (stroke, myocardial infarction, angina pectoris, cardiac death) were recorded. Known cardiovascular risk factors: age, gender, arterial blood pressure, diabetes, renal function, CV history, BMI, dyslipidemia and the INDANA and Framingham scores were measured 6 months, 5 and 10 years after transplantation and were related to the occurrence of MACE. INDANA CV risk score considers age, sex, systolic BP, total cholesterol, height, serum creatinine, smoking, diabetes, left ventricular hypertrophy, history of stroke, history of myocardial infarction. Results: Median follow up of the 425 pts was 5,1 years (Inter Quartile Range, IRQ: 3–7,7), median age was 46 years (IQR: 36–54), median waiting time for transplant was 2,8 years (IQR: 1,7–5,6). During the follow-up 32/425 patients (7,5%) encountered MACE. The incidence of MACE was 0.5% during the first 6 months post-transplantation, 2,2 % between 6 months and 3 years; 3,8 % between 3 years and 5 years and 20,6 % between 5 years and 10 years post-tx. The INDANA score in the considered periods was significantly higher in patients who developed MACE ( p<0.004) while no significant differences were observed analyzing the Framinghan score (p<0.1). Conclusions: Our data indicate that the INDANA scoring system can better predict the risk of MACE occurring in the renal transplant population respect to the Framingham scoring system. The inclusion of the renal function (creatinine) in the INDANA score may explain the better predictive CV risk capability in renal transplant recipients. We conclude that the INDANA score can be useful to evaluate the CV risk in the follow up after renal transplantation.