Características imagenológicas por angiotomografía coronaria en pacientes de un programa de trasplante renal en Barranquilla - Colombia
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Fecha
2022
Autores
Rua Osorio, Zenen David
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Ediciones Universidad Simón Bolívar
Facultad de Ciencias de la Salud
Facultad de Ciencias de la Salud
Resumen
La enfermedad cardiovascular es la principal causa de morbimortalidad en
pacientes con enfermedad renal crónica. En los pacientes trasplantados, la
enfermedad arterial coronaria aumenta el riesgo de muerte y pérdida del injerto
en 2,7 veces; esta condición es más común en el primer año después del
trasplante.
Objetivo: Describir las características imagenológicas por angiotomografía de la
enfermedad coronaria en los pacientes con enfermedad renal crónica en el
programa de trasplante renal de una clínica de cuarto nivel en la ciudad de
Barranquilla-Colombia.
Metodología: Se realizó un estudio analítico, retrospectivo, transversal, se
tomaron las historias clínicas del programa de pretrasplante a todos los
pacientes que requirieron valoración por el servicio de cardiología, se les realizó
angiotomografía, con la finalidad de evaluar CAD-RADS, Carga de Placa y Tipo
de Placa por segmento arterial coronario. Se realizó asociación entre estas
variables a través de un χ² o un test exacto de Fisher, según el caso. Se realizó
un análisis de frecuencia, y representación porcentual de acuerdo con el tipo de
variable.
Resultados: La población estuvo conformada por 236 pacientes de los cuales
80 cumplieron criterios de inclusión y exclusión. La proporción sexual fue de dos
mujeres por cada tres hombres, es decir con una representación del 60%
hombres. La edad promedio fue de 56±6.1años sin diferencia significativa entre
los sexos (W: 855; p-valor: 0.3948). La HTA fue la comorbilidad más frecuente.
El 92% de los pacientes estaban en TRR. El 67.35% de los pacientes tenían
CAD-RADS entre 1 y 2, con unas cargas de placa Leve (53.06%) a moderada
(22.56%), se encontró asociación entre estos dos parámetros (p: 0.0000). En
cuanto al tipo de placa relacionado con la Carga de placa no se evidenció
relación entre estas dos variables (p > 0.05), siendo los tipos de placa más
frecuentes el Calcifica y Fibrocalcifica No Alto Riesgo.
Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease. In transplant patients, coronary artery disease increases the risk of death and graft loss by 2.7 times; this condition is most common in the first year after transplant. Objective: To describe the imaging characteristics of coronary artery disease by CT angiography in patients with chronic kidney disease in the kidney transplant program of a fourth-level clinic in the city of Barranquilla-Colombia. Methodology: An analytical, retrospective, cross-sectional study was carried out, the medical records of the pre-transplant program were taken from all the patients who required evaluation by the cardiology service, they underwent angiotomography, with the purpose of evaluating CAD-RADS, load of Plaque and Plaque Type by coronary artery segment. An association was made between these variables through a χ² or Fisher's exact test, depending on the case. An analysis of frequency and percentage representation according to the type of variable was performed. Results: The population consisted of 236 patients, of which 80 met the inclusion and exclusion criteria. The sexual proportion was two women for every three men, that is, with a representation of 60% men. The average age was 56±6.1 years with no significant difference between the sexes (W: 855; p-value: 0.3948). Hypertension was the most frequent comorbidity. 92% of the patients were on RRT. 67.35% of the patients had CAD-RADS between 1 and 2, with Mild (53.06%) to moderate (22.56%) plate loads, an association was found between these two parameters (p: 0.0000). Regarding the type of plaque related to plaque load, there was no evidence of a relationship between these two variables (p > 0.05), with the most frequent types of plaque being Calcific and Fibrocalcific Non-High Risk.
Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease. In transplant patients, coronary artery disease increases the risk of death and graft loss by 2.7 times; this condition is most common in the first year after transplant. Objective: To describe the imaging characteristics of coronary artery disease by CT angiography in patients with chronic kidney disease in the kidney transplant program of a fourth-level clinic in the city of Barranquilla-Colombia. Methodology: An analytical, retrospective, cross-sectional study was carried out, the medical records of the pre-transplant program were taken from all the patients who required evaluation by the cardiology service, they underwent angiotomography, with the purpose of evaluating CAD-RADS, load of Plaque and Plaque Type by coronary artery segment. An association was made between these variables through a χ² or Fisher's exact test, depending on the case. An analysis of frequency and percentage representation according to the type of variable was performed. Results: The population consisted of 236 patients, of which 80 met the inclusion and exclusion criteria. The sexual proportion was two women for every three men, that is, with a representation of 60% men. The average age was 56±6.1 years with no significant difference between the sexes (W: 855; p-value: 0.3948). Hypertension was the most frequent comorbidity. 92% of the patients were on RRT. 67.35% of the patients had CAD-RADS between 1 and 2, with Mild (53.06%) to moderate (22.56%) plate loads, an association was found between these two parameters (p: 0.0000). Regarding the type of plaque related to plaque load, there was no evidence of a relationship between these two variables (p > 0.05), with the most frequent types of plaque being Calcific and Fibrocalcific Non-High Risk.
Descripción
Palabras clave
Angiotomografía coronaria, CAD-RADS, Carga de Placa, Trasplante renal, Enfermedad cardiovascular, Enfermedad renal crónica, Coronary angiotomography, Plate Load, Kidney transplant, Cardiovascular disease, Chronic kidney disease