Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Predicting cardiovascular problems in liver transplant patients

02.03.2006


New study finds PROCAM and SCORE most accurate



Two methods of assessing a patient’s risk of cardiovascular events--SCORE and PROCAM--proved more valuable for liver transplant recipients than an alternative method, according to a new study. These findings are published in the March 2006 issue of Liver Transplantation, the official journal of the American Association for the Study of Liver Diseases (AASLD) and the International Liver Transplantation Society (ILTS). Published on behalf of the societies by John Wiley & Sons, Inc., the journal is available online via Wiley InterScience (www.interscience.wiley.com/journal/livertransplantation).

Patients who receive liver transplants often have an increased prevalence of cardiovascular risk factors, and cardiovascular events are a major source of their morbidity and mortality. Due to excellent long-term survival, there is an increasing emphasis on identifying transplant recipients at risk for immunosuppression-related late complications. Understanding each transplant recipient’s risk for cardiovascular events is one important consideration.


In search of the best method of estimating a patient’s risk of a cardiovascular event, researchers led by Dr. Olaf Guckelberger of the Department of General, Visceral and Transplantation Surgery at Charité – Campus Vichow-Klinikum in Berlin, Germany, sought to identify relevant independent variables, as well as the algorithm that would most accurately quantify a transplant candidate’s risk of future cardiovascular disease.

The researchers retrospectively studied 303 patients who had received a liver transplant between 1988 and 1994. They gathered clinical and demographic data at six months post-transplant, including age, gender, smoking-status, family history of cardiovascular disease, arterial blood pressure, height, weight, medication and serum levels of creatinine, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglycerides, and glucose after fasting. They then used this data to calculate three established cardiovascular risk scores: the Framingham risk score (FRS), the German Prospective Cardiovascular Münster Study (PROCAM), and the European Systematic Coronary Risk Evaluation Project (SCORE), all of which predict the 10-year-risk of coronary or cardiovascular events or fatalities. They compared the actual incidence of cardiovascular events, such as myocardial infarction and coronary heart disease, over 10 years post-transplant to better understand the predictive power of each score.

"In our liver transplant population at six months post-transplantation, PROCAM and SCORE provided an excellent measure to discriminate between patients at high or low risk for coronary events," the authors report. The Framingham risk score, however, did not identify high-risk liver transplant recipients as accurately.

In an editorial published in the same issue, Christopher P. Appleton, M.D. and colleagues of the Mayo Clinic confirm that assessing short and long term cardiovascular risk is an important aspect of pre-liver transplant evaluation, however, they suggest that the Framingham risk score does have some predictive power.

While they agree with Guckelberger’s assertions that it is important to determine cardiovascular risk in patients in need of a liver transplant, the authors add, "The assertion that there are significant differences in the three global CV disease risk stratification algorithms studies is less certain." They suggest that aspects of the study--such as information about transplant patients who were not included--require further investigation.

Both groups of authors propose additional studies to validate the current findings before applying them to liver transplant populations. Appleton, et al., suggest future prospective studies that add newer reported risk factors to those previously established, including serum high sensitivity C-reactive protein, fibrinogen, homocysteine, lipoprotein and apolipoproteins A1 and B.

David Greenberg | EurekAlert!
Further information:
http://www.interscience.wiley.com/journal/livertransplantation

More articles from Health and Medicine:

nachricht Tracking movement of immune cells identifies key first steps in inflammatory arthritis
23.01.2017 | Massachusetts General Hospital

nachricht Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Quantum optical sensor for the first time tested in space – with a laser system from Berlin

For the first time ever, a cloud of ultra-cold atoms has been successfully created in space on board of a sounding rocket. The MAIUS mission demonstrates that quantum optical sensors can be operated even in harsh environments like space – a prerequi-site for finding answers to the most challenging questions of fundamental physics and an important innovation driver for everyday applications.

According to Albert Einstein's Equivalence Principle, all bodies are accelerated at the same rate by the Earth's gravity, regardless of their properties. This...

Im Focus: Traffic jam in empty space

New success for Konstanz physicists in studying the quantum vacuum

An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...

Im Focus: How gut bacteria can make us ill

HZI researchers decipher infection mechanisms of Yersinia and immune responses of the host

Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...

Im Focus: Interfacial Superconductivity: Magnetic and superconducting order revealed simultaneously

Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.

While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...

Im Focus: Studying fundamental particles in materials

Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales

Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Sustainable Water use in Agriculture in Eastern Europe and Central Asia

19.01.2017 | Event News

12V, 48V, high-voltage – trends in E/E automotive architecture

10.01.2017 | Event News

2nd Conference on Non-Textual Information on 10 and 11 May 2017 in Hannover

09.01.2017 | Event News

 
Latest News

Tracking movement of immune cells identifies key first steps in inflammatory arthritis

23.01.2017 | Health and Medicine

Electrocatalysis can advance green transition

23.01.2017 | Physics and Astronomy

New technology for mass-production of complex molded composite components

23.01.2017 | Process Engineering

VideoLinks
B2B-VideoLinks
More VideoLinks >>>