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 New study points the way to therapy for rare cancer that targets the young
22.11.2017 | Rockefeller University

nachricht Penn study identifies new malaria parasites in wild bonobos
21.11.2017 | University of Pennsylvania School of Medicine

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: New proton record: Researchers measure magnetic moment with greatest possible precision

High-precision measurement of the g-factor eleven times more precise than before / Results indicate a strong similarity between protons and antiprotons

The magnetic moment of an individual proton is inconceivably small, but can still be quantified. The basis for undertaking this measurement was laid over ten...

Im Focus: Frictional Heat Powers Hydrothermal Activity on Enceladus

Computer simulation shows how the icy moon heats water in a porous rock core

Heat from the friction of rocks caused by tidal forces could be the “engine” for the hydrothermal activity on Saturn's moon Enceladus. This presupposes that...

Im Focus: Nanoparticles help with malaria diagnosis – new rapid test in development

The WHO reports an estimated 429,000 malaria deaths each year. The disease mostly affects tropical and subtropical regions and in particular the African continent. The Fraunhofer Institute for Silicate Research ISC teamed up with the Fraunhofer Institute for Molecular Biology and Applied Ecology IME and the Institute of Tropical Medicine at the University of Tübingen for a new test method to detect malaria parasites in blood. The idea of the research project “NanoFRET” is to develop a highly sensitive and reliable rapid diagnostic test so that patient treatment can begin as early as possible.

Malaria is caused by parasites transmitted by mosquito bite. The most dangerous form of malaria is malaria tropica. Left untreated, it is fatal in most cases....

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

Lightning, with a chance of antimatter

24.11.2017 | Earth Sciences

A huge hydrogen generator at the Earth's core-mantle boundary

24.11.2017 | Earth Sciences

Scientists find why CP El Niño is harder to predict than EP El Niño

24.11.2017 | Earth Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>