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INCIDENCE OF NEW CORONARY RISK FACTORS AND OF CORONARY ARTERY DISEASE AFTER LIVER TRANSPLANTATION ASSOCIATED WITH DRUGS TO PREVENT REJECTION FREE TO VIEW

Harshad Amin, MD*; Wilbert S. Aronow, MD; Kaushang Gandhi, MD; Harit Desai, MD; Hoang M. Lai, MD; Tarun Chugh, MD; Dhaval Shah, MD; David C. Wolf, MD
Author and Funding Information

New York Medical College, Valhalla, NY


Chest


Chest. 2009;136(4_MeetingAbstracts):7S. doi:10.1378/chest.136.4_MeetingAbstracts.7S-g
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Abstract

PURPOSE:  To investigate incidence of new coronary risk factors and of coronary artery disease (CAD) after liver transplantation associated with drugs to prevent transplant rejection.

METHODS:  We investigated in 200 patients, mean age 58 years, the incidence of new coronary risk factors and CAD after liver transplantation associated with drugs to prevent transplant rejection. All patients received prednisone for the first 3 months after transplantation. For the 2 years after transplantation, 36 patients were treated with cyclosporine plus mycophenolate (group A), 154 with tacrolimus plus mycophenolate (group B), and 10 with prednisone plus tacrolimus or cyclosporine plus mycophenolate (group C). Mean follow-up was 2 years.

RESULTS:  New hypertension developed in 18 of 36 group A patients (50%), in 47 of 154 group B patients (31%), and in 6 of 10 group C patients (60%) (p <0.05 comparing A with B and C with B). New diabetes developed in 4 of 36 group A patients (11%), in 24 of 154 group B patients (16%), and in 5 of 10 group C patients (50%) (p <0.01 comparing C with A and C with B). New hypercholesterolemia developed in 12 of 36 group A patients (33%), in 25 of 154 group B patients (16%), and in 5 of 10 group C patients (50%) (p <0.02 comparing A with B and p <0.01 comparing C with B). Statins were used in 22 of 200 patients (11%). New CAD developed in 5 of 36 group A patients (14%), in 5 of 154 group B patients (3%), and in 2 of 10 group C patients (20%) (p<0.001 comparing A with B and p<0.01 comparing C with B).

CONCLUSION:  During 2 years after liver transplantation, the incidence of hypertension increased 36%, of diabetes increased 17%, of hypercholesterolemia increased 21%, and of CAD increased 6% associated with use of drugs to prevent transplant rejection.

CLINICAL IMPLICATIONS:  After liver transplantation, coronary risk factors should be intensively treated including use of statins to treat hypercholesterolemia.

DISCLOSURE:  Harshad Amin, No Financial Disclosure Information; No Product/Research Disclosure Information

Monday, November 2, 2009

10:30 AM - 12:00 PM


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