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 21 April 2018

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News

Validation of cardiovascular risk scores for liver transplants

The Systematic Coronary Risk Evaluation Project and Prospective Cardiovascular Münster Study risk scores identify liver transplant recipients for their individual risk of cardiovascular events, reports this month's Liver Transplantation.

News image

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Increased prevalence of cardiovascular risk factors has been acknowledged in liver transplant recipients.

An increased incidence of cardiovascular events has been suspected.

Individual risk determination, however, has not yet been established.

Dr Olaf Guckelberger and colleagues from Germany reviewed outpatient charts of 438 primary liver transplants.

Suspected cardiovascular risk factors were correlated with cardiovascular events observed during a follow-up period of 10 years.

Receiver operation characteristics curve analysis was performed to validate established cardiovascular risk scores.

For calibration, the Hosmer-Lemeshow test was performed.

The research team reported that a total of 303 of 438 patients were available for risk factor analysis at 6 months and demonstrated complete follow-up data.

The team noted that 13% of these patients experienced fatal or nonfatal cardiovascular events.

Age, gender, and cholesterol were the only independent predictors of events
Liver Transplantation

In univariate analysis, age, gender, body mass index, cholesterol, and creatinine were associated with cardiovascular events.

The researchers also found that diabetes mellitus, glucose, and systolic blood pressure were associated with cardiovascular events.

The team observed that cyclosporine A, tacrolimus, or steroid medication, were not significantly associated with cardiovascular events.

Multivariate analysis, however, identified only age, gender, and cholesterol as independent predictors.

Corresponding areas under the curve for Systematic Coronary Risk Evaluation Project (SCORE) was calculated as 0.8.

The team calculated areas under the curve for the Prospective Cardiovascular Münster Study (PROCAM), and Framingham risk scores as 0.778, and 0.707, respectively.

The team demonstrated with calibrations an improved goodness of fit for Prospective Cardiovascular Münster Study vs Systematic Coronary Risk Evaluation Project risk calculations.

Dr Guckelberger's team concludes, “Systematic Coronary Risk Evaluation Project and Prospective Cardiovascular Münster Study proved to be valuable in discriminating our liver transplant recipients for their individual risk of cardiovascular events.”

“Furthermore, calibrated Prospective Cardiovascular Münster Study risk estimates are required to calculate the number of patients needed to treat in the set-up of prospective intervention trials.”

Liv Transplant 2006: 12(3): 394-401
03 March 2006

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