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Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients

BACKGROUND: Mortality in allograft kidney transplant recipients is high, and cardiovascular disease is the leading cause of death in these patients. They have heightened activity of sympathetic and renin–angiotensin systems. We tested the hypothesis that blockade of sympathetic and renin–angiotensin...

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Autores principales: Aftab, Waqas, Varadarajan, Padmini, Rasool, Shuja, Kore, Arputharaj, Pai, Ramdas G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Blackwell Publishing Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603267/
https://www.ncbi.nlm.nih.gov/pubmed/23525422
http://dx.doi.org/10.1161/JAHA.112.000091
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author Aftab, Waqas
Varadarajan, Padmini
Rasool, Shuja
Kore, Arputharaj
Pai, Ramdas G.
author_facet Aftab, Waqas
Varadarajan, Padmini
Rasool, Shuja
Kore, Arputharaj
Pai, Ramdas G.
author_sort Aftab, Waqas
collection PubMed
description BACKGROUND: Mortality in allograft kidney transplant recipients is high, and cardiovascular disease is the leading cause of death in these patients. They have heightened activity of sympathetic and renin–angiotensin systems. We tested the hypothesis that blockade of sympathetic and renin–angiotensin systems in these patients may offer a survival benefit using a large cohort of patients with long‐term follow up. METHODS AND RESULTS: Medical records of 321 consecutive patients from our institution who had received renal transplantation between 1995 and 2003 were abstracted. Survival was analyzed as a function of pharmacological therapies adjusted for age, sex, and comorbidities. The characteristics of the 321 patients were as follows: age at transplant, 44±13 years; 40% male; 89% with hypertension; 36% with diabetes, and mean left ventricular ejection fraction of 60%. Over a follow‐up of 10±4 years, there were 119 deaths. Adjusted for age, sex, diabetes, and coronary artery disease, use of a beta‐blocker therapy (P=0.04) and angiotensin‐converting enzyme inhibitor or receptor blocker (P=0.03) was associated with better survival. This treatment effect was seen across all major clinical subgroups and was supported by propensity score analysis. The propensity score–adjusted 10‐year survival was 95% in those taking both groups of medications, 72% in those taking either of them, and 64% in those taking neither (P=0.004). CONCLUSIONS: Use of beta‐blocker and angiotensin blocking therapies is associated with higher survival after renal transplantation, indicating their potential protective role in this high‐risk population.
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spelling pubmed-36032672013-03-27 Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients Aftab, Waqas Varadarajan, Padmini Rasool, Shuja Kore, Arputharaj Pai, Ramdas G. J Am Heart Assoc Original Research BACKGROUND: Mortality in allograft kidney transplant recipients is high, and cardiovascular disease is the leading cause of death in these patients. They have heightened activity of sympathetic and renin–angiotensin systems. We tested the hypothesis that blockade of sympathetic and renin–angiotensin systems in these patients may offer a survival benefit using a large cohort of patients with long‐term follow up. METHODS AND RESULTS: Medical records of 321 consecutive patients from our institution who had received renal transplantation between 1995 and 2003 were abstracted. Survival was analyzed as a function of pharmacological therapies adjusted for age, sex, and comorbidities. The characteristics of the 321 patients were as follows: age at transplant, 44±13 years; 40% male; 89% with hypertension; 36% with diabetes, and mean left ventricular ejection fraction of 60%. Over a follow‐up of 10±4 years, there were 119 deaths. Adjusted for age, sex, diabetes, and coronary artery disease, use of a beta‐blocker therapy (P=0.04) and angiotensin‐converting enzyme inhibitor or receptor blocker (P=0.03) was associated with better survival. This treatment effect was seen across all major clinical subgroups and was supported by propensity score analysis. The propensity score–adjusted 10‐year survival was 95% in those taking both groups of medications, 72% in those taking either of them, and 64% in those taking neither (P=0.004). CONCLUSIONS: Use of beta‐blocker and angiotensin blocking therapies is associated with higher survival after renal transplantation, indicating their potential protective role in this high‐risk population. Blackwell Publishing Ltd 2013-02-22 /pmc/articles/PMC3603267/ /pubmed/23525422 http://dx.doi.org/10.1161/JAHA.112.000091 Text en © 2013 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley-Blackwell. http://creativecommons.org/licenses/by/2.5/ This is an Open Access article under the terms of the Creative Commons Attribution Noncommercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Aftab, Waqas
Varadarajan, Padmini
Rasool, Shuja
Kore, Arputharaj
Pai, Ramdas G.
Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients
title Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients
title_full Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients
title_fullStr Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients
title_full_unstemmed Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients
title_short Beta and Angiotensin Blockades Are Associated With Improved 10‐Year Survival in Renal Transplant Recipients
title_sort beta and angiotensin blockades are associated with improved 10‐year survival in renal transplant recipients
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3603267/
https://www.ncbi.nlm.nih.gov/pubmed/23525422
http://dx.doi.org/10.1161/JAHA.112.000091
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