Cardiovascular outcomes in de novo Kidney transplant recipients receiving everolimus and reduced calcineurin inhibitor or standard triple therapy: 24-month post hoc analysis from TRANSFORM study

Background. - The comparative impact of everolimus (EVR)-based regimens versus standard of care (mycophenolic acid+standard calcineurin inhibitor [MPA+sCNI]) on cardiovascular outcomes in de novo kidney transplant recipients (KTRs) is poorly understood. The incidence of major adverse card...

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Main Authors: Sommerer, Claudia (Author) , Legendre, Christophe (Author) , Citterio, Franco (Author) , Watarai, Yoshihiko (Author) , Oberbauer, Rainer (Author) , Basic-Jukic, Nikolina (Author) , Han, Jackie (Author) , Gawai, Apurva (Author) , Bernhardt, Peter (Author) , Chadban, Steve (Author)
Format: Article (Journal)
Language:English
Published: July 2023
In: Transplantation
Year: 2023, Volume: 107, Issue: 7, Pages: 1593-1604
ISSN:1534-6080
DOI:10.1097/TP.0000000000004555
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1097/TP.0000000000004555
Verlag, lizenzpflichtig, Volltext: https://journals.lww.com/transplantjournal/fulltext/2023/07000/cardiovascular_outcomes_in_de_novo_kidney.25.aspx
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Author Notes:Claudia Sommerer, Christophe Legendre, Franco Citterio, Yoshihiko Watarai, Rainer Oberbauer, Nikolina Basic-Jukic, Jackie Han, Apurva Gawai, Peter Bernhardt, and Steve Chadban
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Summary:Background. - The comparative impact of everolimus (EVR)-based regimens versus standard of care (mycophenolic acid+standard calcineurin inhibitor [MPA+sCNI]) on cardiovascular outcomes in de novo kidney transplant recipients (KTRs) is poorly understood. The incidence of major adverse cardiac events (MACEs) in KTRs receiving EVR+reduced CNI (rCNI) or MPA+sCNI from the TRANSplant eFficacy and safety Outcomes with an eveRolimus-based regiMen study was evaluated. - Methods. - The incidence of MACE was determined for all randomized patients receiving at least 1 dose of the study drug. Factors associated with MACEs were determined by logistic regression. Risk of MACE out to 3 y post-study was calculated using the Patient Outcome in Renal Transplantation equation. - Results. - MACE occurred in 81 of 1014 (8.0%; EVR+rCNI) versus 89 of 1012 (8.8%; MPA+sCNI) KTRs (risk ratio, 0.91 [95% confidence interval [CI], 0.68-1.21]). The incidence of circulatory death, myocardial infarction, revascularization, or angina was similar between the arms. Incidence of MACE was similar between EVR+rCNI and MPA+sCNI arms with a higher incidence in prespecified risk groups: older age, pretransplant diabetes (15.1% versus 15.9%), statin use (8.5% versus 10.8%), and low estimated glomerular filtration rate (Month 2 estimated glomerular filtration rate <30 versus >60 mL/min/1.73 m2; odds ratio, 2.23 [95% CI, 1.02-4.86]; P = 0.044), respectively. Predicted risk of MACE within 3 y of follow-up did not differ between the treatment arms. - Conclusions. - Cardiovascular morbidity and mortality were similar between de novo KTRs receiving EVR+rCNI and MPA+sCNI. EVR+rCNI is a viable alternative to the current standard of care in KTRs. - - - - - Export
Item Description:Gesehen am 09.01.2024
Physical Description:Online Resource
ISSN:1534-6080
DOI:10.1097/TP.0000000000004555