Long‐term cardiovascular outcome of renal transplant recipients after early conversion to everolimus compared to calcineurin inhibition: results from the randomized controlled MECANO trial. (28th August 2018)

• Record Type: Journal Article
• Authors: van Dijk, Marja; van Roon, Arie M.; Said, M. Yusof; Bemelman, Frederike J.; Homan van der Heide, Jaap J.; de Fijter, Hans W.; de Vries, Aiko P. J.; Bakker, Stephan J. L.; Sanders, Jan Stephan F.
• Is Part Of: Transplant international. Volume 31:Number 12(2018)
• Page Start: 1380
• Page End: 1390
• Publication Date: 2018-08-28
• Subjects: cardiovascular outcome -- immunosuppression -- intima media thickness -- kidney transplantation; Transplantation of organs, tissues, etc -- Periodicals; 617.95405
• DOI: 10.1111/tri.13322
• Languages: English
• ISSNs: 0934-0874

Abstract

Summary: Long‐term data on cardiovascular (CV) outcome of renal transplant recipients (RTR) on mTOR‐i (mammalian Target Of Rapamycin‐inhibitors) are scarce. In a sub‐study of the MECANO trial we investigated changes in intima media thickness (IMT), CV risk profile, Major Adverse CV Events (MACE) and survival in RTR on a mTORi versus CNI based regimen. Patients (enrolled 361) were treated with (basiliximab) and triple IS (CsA‐Cyclosporine A‐(C), MPS (M), prednisolone (P)). At M6 patients were randomized ( n = 224) to the CsA group (C, P, N = 89), MPS group (M, P, N = 39) EVL group (Everolimus, P, N = 96). At week 2, M6 and M 24, IMT measurements of the Common Carotid Artery were performed. Cardiovascular risk factors were assessed at baseline, 6 and 24 months of follow‐up. Seven years survival and MACE‐free survival probability were calculated by the Cardiovascular Risk Calculator for RTR. After 7 years of follow‐up, incidence of cardiovascular events and patient survival were assessed. Mean IMT at baseline ( N = 192), was 0.64 ± 0.14 mm. At M6 ( N = 158), 0.66 ± 0.15, M24 IMT was 0.68 ± 0.15 ( N = 95). No significant differences between groups concerning IMT, true CV events and mortality, CV risk profile, predicted MACE/Mortality were found between mTORi and CNI‐based regimen after 7 years of follow‐up.