Hernández, DomingoTriñanes, JavierSalido, EduardoPitti, SergioRufino, MargaritaGonzález-Posada, José ManuelTorres, Armando2024-01-152024-01-152015-06-12http://hdl.handle.net/10668/2325http://hdl.handle.net/20.500.12105/17094BACKGROUND: Kidney transplant recipients have high cardiovascular risk, and vascular inflammation may play an important role. We explored whether the inflammatory state in the vessel wall was related to carotid intima-media thickness (c-IMT) and patient survival following kidney transplantation. METHODS: In this prospective observational cohort study we measured c-IMT and expression of proinflammatory cytokines and adhesion molecules in the inferior epigastric artery in 115 kidney transplant candidates. Another c-IMT measurement was done 1-year post-transplantation in 107. By stepwise multiple regression analysis we explored factors associated with baseline c-IMT and their changes over time. Multivariate Cox regression analysis was constructed to identify risk factors for mortality. RESULTS: A worse cardiovascular profile (older age, smoker, diabetic, carotid plaque, systolic blood pressure and vascular calcification) and higher VCAM-1 levels were found in patients in the highest baseline c-IMT tertile, who also had a worse survival. Factors independently related to baseline c-IMT were age (β=0.369, P<0.0001), fasting glucose (β=0.168, P=0.045), smoking (β=0.228, P=0.003) and VCAM-1 levels (β=0.244, P=0.002). Independent factors associated with c-IMT measurement 1-year post-transplantation were baseline c-IMT (β=-0.677, P<0.0001), post-transplant diabetes (β=0.225, P=0.003) and triglycerides (β=0.302, P=0.023). Vascular VCAM-1 levels were associated with increased risk of mortality in bivariate and multivariate Cox regression. Notably, nearly 50% of patients showed an increase or maintenance of high c-IMT 1 year post-transplantation and these patients experienced a higher mortality (13 versus 3.5%; P=0.021). CONCLUSION: A worse cardiovascular profile and a higher vascular VCAM-1 protein levels at time of KT are related to subclinical atheromatosis. This could lead to a higher post-transplant mortality. Pre-transplant c IMT, post-transplant diabetes and triglycerides at 1-year post-transplantation may condition a high c-IMT measurement post-transplantation, which may decrease patient survival.engVoRhttps://creativecommons.org/licenses/by/4.0/AterosclerosisPresión sanguíneaEnfermedades cardiovascularesMoléculas de adhesión celularEstudios de cohortesCitocinasDiabetes mellitusArterias epigástricasAyunoInflamaciónTrasplante de riñónFactores de riesgoHábito de fumarTriglicéridosCalcificación vascularAtherosclerosisBlood PressureCardiovascular DiseasesCarotid Intima-Media ThicknessCell Adhesion MoleculesCohort StudiesCytokinesisDiabetes MellitusEpigastric ArteriesFastingGlucoseHumansInflammationKidneyKidney TransplantationProspective StudiesRegression AnalysisRisk FactorsHabitsTriglyceridesVascular CalcificationVascular Cell Adhesion Molecule-1Attribution 4.0 International2606604510.1371/journal.pone.01290831932-6203PloS Oneopen access