Heart failure & cardiomyopathiesCohort study
Cardiovascular-Kidney-Metabolic Disease Burden in Children and Adults Following Heart Transplantation
- Retrospective cohort study
- single-centre
Authors' conclusion
A significant proportion of HT recipients experience new-onset or worsening CKM dysfunction after HT. Furthermore, CKM comorbidities are associated with post-HT mortality.
Study context
- Population
- Adults and children who underwent heart transplantation (HT), January 2015 to June 2024
- Participants
- 860 vs 84
- Exposure
- Adults vs Children
- Adultsn = 860
- Childrenn = 84
- Outcome
- Incidence and prevalence of CKM risk factors (T2DM, overweight/obesity, hypertension, CKD, dyslipidaemia) and their association with CAV and mortality
Main finding
As reported in the abstract
| Group | T2DM | Overweight or obesity | Dyslipidaemia | Chronic kidney disease (CKD) |
|---|---|---|---|---|
| Adults | 28.6 | 77.3 | 139.1 | 69.7 |
| Children | 2.8 | 26.9 | 5.5 | 3.6 |
Observational data: associations, not effects.
Further findings
Cardiovascular-kidney-metabolic (CKM) comorbidities and cardiac allograft vasculopathy (CAV) / post-HT mortality
| Comparison | HR (95% CI) | |
|---|---|---|
| DM2 · post-HT mortality · time-varying Cox regression | 1.84 (1.04–3.25) | |
| 0.20.5125Hazard ratio (log scale) |
Cardiometabolic dysfunction in adults · within 12 months post-HT
- Stage 1 or 2 hypertension
- 99%
- HbA1c ≥6.5%, regardless of preexisting diabetes mellitus (DM2)
- 22.1%
- Moderate to severe hypertriglyceridemia
- 37.5%
- Worsened LDL-C control
- 31.1%
Worsening renal function (estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m²) in adults with pre-HT eGFR ≥45 · within 12 months post-HT
- Worsening renal function
- 86.2%
eGFR after SGLT2 inhibitor initiation post-HT (adults, n = 242) · ensuing 12 months
- Nonlinear improvement in eGFR
BMI after GLP1RA initiation (adults, n = 168)
- Predominantly linear reduction in BMI
CKM comorbidities and CAV / post-HT mortality
- No CKM comorbidity significantly associated with CAV
Original publication
Summarised from the published abstract; every number is checked against it