Transplant International (Mar 2024)

Metabolic Syndrome and Heart Transplantation: An Underestimated Risk Factor?

  • 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

DOI
https://doi.org/10.3389/ti.2024.11075
Journal volume & issue
Vol. 37

Abstract

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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.

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