Cardiovascular risk factors associated with cardiac allograft vasculopathy following cardiac transplantation: A longitudinal follow-up

Background: Cardiac allograft vasculopathy (CAV) in the post-cardiac transplant population is partially attributed to the presence of traditional cardiovascular (CV) risk factors. In order to provide optimal care post-transplant, early identification of modifiable CV risk factors needs to be undertaken and managed appropriately. The purpose of this retrospective project was to: examine the incidence of the CV risk factors of hyperlipidaemia, hypertension, diabetes and obesity in this population, and compare the results with those reported worldwide by the International Society of Heart and Lung Transplantation (ISHLT). Methods: A retrospective audit was undertaken to determine the prevalence of the CV risk factors up to five years after orthotopic heart transplant. A non-random convenience sample was utilised at the Alfred Hospital, Melbourne, Australia. Results: Changes in CV risk factors from baseline to five years after cardiac transplantation were observed in 25 patients (mean age 50 years ±13 with a majority males, n=21). Primary diagnoses were cardiomyopathy, ischaemic heart disease (IHD) and congenital heart disease. Significant differences were observed from baseline to five years post-transplant in systolic blood pressure (BP) (p=.001) and body mass index (BMI) (p<0.001). Five years after transplant, raised cholesterol levels and BMI greater than 25 kg/m²was observed in over 80%, with raised systolic BP in 42% and diabetes in over a quarter of subjects. Conclusion: This retrospective audit supports monitoring traditional CV risk factors in this vulnerable population. The incidence of CV risk factors identified correlates with ISHLT's reports on this population.