Impact of renal impairment on cardiovascular disease mortality after liver transplantation for nonalcoholic steatohepatitis cirrhosis.
Impact of renal impairment on cardiovascular disease mortality after liver transplantation for nonalcoholic steatohepatitis cirrhosis.
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DOI：
10.1111/liv.12872
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发表时间：
2015-12
期刊：
影响因子：
--
通讯作者：
Rinella ME
中科院分区：
文献类型：
--
作者：
VanWagner LB;Lapin B;Skaro AI;Lloyd-Jones DM;Rinella ME
非酒精性脂肪性肝炎（NASH）是肝移植后心血管疾病（CVD）发病的独立危险因素，但其对 CVD 死亡率的影响尚不清楚。我们试图评估 NASH 对肝移植后 CVD 死亡率的影响，并预测哪些 NASH 接受者在肝移植后发生 CVD 相关死亡的风险最高。使用器官采购和移植网络数据库，我们研究了 NASH 与肝移植后 CVD 死亡率之间的关联，CVD 死亡率被定义为血栓栓塞、心律失常、心力衰竭、心肌梗死或中风导致死亡的主要原因。医生小组审查了死亡原因。在 48,360 例肝移植中（2/2002-12/2011），5,057 例（10.5%）是因 NASH 肝硬化而进行的。与非 NASH 患者相比，NASH 患者更有可能是老年、女性、肥胖、糖尿病患者，并且有肾功能衰竭病史或既往有 CVD 病史（所有患者的 p<0.001）。尽管总体全因死亡率没有差异（对数秩 p=0.96），但 NASH 接受者的早期（30 天）和长期 CVD 特异性死亡率均增加（比值比=1.30，95% 置信区间 (CI)：1.02–1.66；风险比=1.42，95% CI：1.07–1.41）。在对移植前糖尿病、肾功能不全或心血管疾病进行调整后，这些关联不再显着。制定了包括年龄 ≥ 55 岁、男性、糖尿病和肾功能不全的风险评分，用于预测肝移植后 CVD 死亡率（c 统计量 0.60）。 NASH 接受者在肝移植后发生 CVD 死亡的风险增加，这是由于共病心脏代谢危险因素的患病率较高，这些因素总体上确定了移植后 CVD 死亡风险最高的人群。
Non-alcoholic steatohepatitis (NASH) is an independent risk factor for cardiovascular disease (CVD) morbidity after liver transplantation, but its impact on CVD mortality is unknown. We sought to assess the impact of NASH on CVD mortality after liver transplantation and to predict which NASH recipients are at highest risk of a CVD-related death following a liver transplant. Using the Organ Procurement and Transplantation Network database we examined associations between NASH and post liver transplant CVD mortality, defined as primary cause of death from thromboembolism, arrhythmia, heart failure, myocardial infarction, or stroke. A physician panel reviewed cause of death. Of 48,360 liver transplants (2/2002–12/2011), 5,057 (10.5%) were performed for NASH cirrhosis. NASH recipients were more likely to be older, female, obese, diabetic, and have history of renal failure or prior CVD versus non-NASH (p<0.001 for all). Although there was no difference in overall all-cause mortality (log-rank p=0.96), both early (30-day) and long-term CVD-specific mortality was increased among NASH recipients (Odds ratio=1.30, 95% Confidence interval (CI): 1.02–1.66; Hazard ratio=1.42, 95% CI: 1.07–1.41, respectively). These associations were no longer significant after adjustment for pre-transplant diabetes, renal impairment or CVD. A risk score comprising age ≥ 55, male sex, diabetes and renal impairment was developed for prediction of post liver transplant CVD mortality (c-statistic 0.60). NASH recipients have an increased risk of CVD mortality after liver transplantation explained by a high prevalence of co-morbid cardiometabolic risk factors that in aggregate identify those at highest risk of post-transplant CVD mortality.
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影响因子：
37.8
作者：
Go AS;Mozaffarian D;Roger VL;Benjamin EJ;Berry JD;Blaha MJ;Dai S;Ford ES;Fox CS;Franco S;Fullerton HJ;Gillespie C;Hailpern SM;Heit JA;Howard VJ;Huffman MD;Judd SE;Kissela BM;Kittner SJ;Lackland DT;Lichtman JH;Lisabeth LD;Mackey RH;Magid DJ;Marcus GM;Marelli A;Matchar DB;McGuire DK;Mohler ER 3rd;Moy CS;Mussolino ME;Neumar RW;Nichol G;Pandey DK;Paynter NP;Reeves MJ;Sorlie PD;Stein J;Towfighi A;Turan TN;Virani SS;Wong ND;Woo D;Turner MB;American Heart Association Statistics Committee and Stroke Statistics Subcommittee
通讯作者：
American Heart Association Statistics Committee and Stroke Statistics Subcommittee
非酒精性脂肪肝病与冠状动脉钙化有关。
影响因子：
13.5
作者：
Kim, Donghee;Choi, Su-Yeon;Park, Eun Ha;Lee, Whal;Kang, Jin Hwa;Kim, Won;Kim, Yoon Jun;Yoon, Jung-Hwan;Jeong, Sook Hyang;Lee, Dong Ho;Lee, Hyo-suk;Larson, Joseph;Therneau, Terry M.;Kim, W. Ray
通讯作者：
Kim, W. Ray
非酒精性脂肪肝病的影响对由时域，频域和心率变异性的符号动态评估的自主变化的影响。
影响因子：
3.7
作者：
Liu YC;Hung CS;Wu YW;Lee YC;Lin YH;Lin C;Lo MT;Chan CC;Ma HP;Ho YL;Chen CH
通讯作者：
Chen CH
影响因子：
2.8
作者：
Lu H;Liu H;Hu F;Zou L;Luo S;Sun L
通讯作者：
Sun L
影响因子：
8.8
作者：
Malik, S. M.;deVera, M. E.;Ahmad, J.
通讯作者：
Ahmad, J.