Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor?
Metabolic Syndrome (MetS), a multifactorial condition that increases the risk of cardio-vascular events, is frequent in Heart-transplant (HTx) candidates and worsens with immunosuppressive therapy. The aim of the study was to analyze the impact of MetS on long-term outcome of HTx patients. Since 200...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2024-03-01
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| Series: | Transplant International |
| Subjects: | |
| Online Access: | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.11075/full |
| _version_ | 1797222389011972096 |
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| author | Sandro Sponga Sandro Sponga Igor Vendramin Veronica Ferrara Michela Marinoni Giulia Valdi Concetta Di Nora Chiara Nalli Giovanni Benedetti Daniela Piani Andrea Lechiancole Maria Parpinel Uberto Bortolotti Ugolino Livi Ugolino Livi |
| author_facet | Sandro Sponga Sandro Sponga Igor Vendramin Veronica Ferrara Michela Marinoni Giulia Valdi Concetta Di Nora Chiara Nalli Giovanni Benedetti Daniela Piani Andrea Lechiancole Maria Parpinel Uberto Bortolotti Ugolino Livi Ugolino Livi |
| author_sort | Sandro Sponga |
| collection | DOAJ |
| description | Metabolic Syndrome (MetS), a multifactorial condition that increases the risk of cardio-vascular events, is frequent in Heart-transplant (HTx) candidates and worsens with immunosuppressive therapy. The aim of the study was to analyze the impact of MetS on long-term outcome of HTx patients. Since 2007, 349 HTx patients were enrolled. MetS was diagnosed if patients met revised NCEP-ATP III criteria before HTx, at 1, 5 and 10 years of follow-up. MetS was present in 35% of patients pre-HTx and 47% at 1 year follow-up. Five-year survival in patients with both pre-HTx (65% vs. 78%, p < 0.01) and 1 year follow-up MetS (78% vs 89%, p < 0.01) was worst. At the univariate analysis, risk factors for mortality were pre-HTx MetS (HR 1.86, p < 0.01), hypertension (HR 2.46, p < 0.01), hypertriglyceridemia (HR 1.50, p=0.03), chronic renal failure (HR 2.95, p < 0.01), MetS and diabetes at 1 year follow-up (HR 2.00, p < 0.01; HR 2.02, p < 0.01, respectively). MetS at 1 year follow-up determined a higher risk to develop Coronary allograft vasculopathy at 5 and 10 year follow-up (25% vs 14% and 44% vs 25%, p < 0.01). MetS is an important risk factor for both mortality and morbidity post-HTx, suggesting the need for a strict monitoring of metabolic disorders with a careful nutritional follow-up in HTx patients. |
| first_indexed | 2024-04-24T13:20:33Z |
| format | Article |
| id | doaj.art-8e7e430a813a42219fcafa98720524b7 |
| institution | Directory Open Access Journal |
| issn | 1432-2277 |
| language | English |
| last_indexed | 2024-04-24T13:20:33Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Transplant International |
| spelling | doaj.art-8e7e430a813a42219fcafa98720524b72024-04-04T16:17:33ZengFrontiers Media S.A.Transplant International1432-22772024-03-013710.3389/ti.2024.1107511075Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor?Sandro Sponga0Sandro Sponga1Igor Vendramin2Veronica Ferrara3Michela Marinoni4Giulia Valdi5Concetta Di Nora6Chiara Nalli7Giovanni Benedetti8Daniela Piani9Andrea Lechiancole10Maria Parpinel11Uberto Bortolotti12Ugolino Livi13Ugolino Livi14Department of Medicine (DAME), University of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyDepartment of Medicine (DAME), University of Udine, Udine, ItalyDepartment of Medicine (DAME), University of Udine, Udine, ItalyDepartment of Medicine (DAME), University of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyDepartment of Medicine (DAME), University of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyDepartment of Medicine (DAME), University of Udine, Udine, ItalyCardiothoracic Department, University Hospital of Udine, Udine, ItalyMetabolic Syndrome (MetS), a multifactorial condition that increases the risk of cardio-vascular events, is frequent in Heart-transplant (HTx) candidates and worsens with immunosuppressive therapy. The aim of the study was to analyze the impact of MetS on long-term outcome of HTx patients. Since 2007, 349 HTx patients were enrolled. MetS was diagnosed if patients met revised NCEP-ATP III criteria before HTx, at 1, 5 and 10 years of follow-up. MetS was present in 35% of patients pre-HTx and 47% at 1 year follow-up. Five-year survival in patients with both pre-HTx (65% vs. 78%, p < 0.01) and 1 year follow-up MetS (78% vs 89%, p < 0.01) was worst. At the univariate analysis, risk factors for mortality were pre-HTx MetS (HR 1.86, p < 0.01), hypertension (HR 2.46, p < 0.01), hypertriglyceridemia (HR 1.50, p=0.03), chronic renal failure (HR 2.95, p < 0.01), MetS and diabetes at 1 year follow-up (HR 2.00, p < 0.01; HR 2.02, p < 0.01, respectively). MetS at 1 year follow-up determined a higher risk to develop Coronary allograft vasculopathy at 5 and 10 year follow-up (25% vs 14% and 44% vs 25%, p < 0.01). MetS is an important risk factor for both mortality and morbidity post-HTx, suggesting the need for a strict monitoring of metabolic disorders with a careful nutritional follow-up in HTx patients.https://www.frontierspartnerships.org/articles/10.3389/ti.2024.11075/fullheart transplantationmetabolic syndromecardiac allograft vasculopathylong-term mortalitylong-term outcome |
| spellingShingle | Sandro Sponga Sandro Sponga Igor Vendramin Veronica Ferrara Michela Marinoni Giulia Valdi Concetta Di Nora Chiara Nalli Giovanni Benedetti Daniela Piani Andrea Lechiancole Maria Parpinel Uberto Bortolotti Ugolino Livi Ugolino Livi Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor? Transplant International heart transplantation metabolic syndrome cardiac allograft vasculopathy long-term mortality long-term outcome |
| title | Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor? |
| title_full | Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor? |
| title_fullStr | Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor? |
| title_full_unstemmed | Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor? |
| title_short | Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor? |
| title_sort | metabolic syndrome and heart transplantation an underestimated risk factor |
| topic | heart transplantation metabolic syndrome cardiac allograft vasculopathy long-term mortality long-term outcome |
| url | https://www.frontierspartnerships.org/articles/10.3389/ti.2024.11075/full |
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