Application Of Common Cardiovascular Risk Assessment Models In Postoperative Risk Prediction Of Liver And Kidney Transplantation Recipients

Objective:1.To analyze the incidence of cardiovascular and cerebrovascular events(CVE)in recipients after liver and kidney transplantation and the distribution of related risk factors in the transplant population;2.To explore whether the "Framingham(FRS)risk assessment model" and the "Ischemic cardiovascular diseases(ICVD)risk assessment model for Chinese people" are suitable for the risk assessment of postoperative cardiovascular events in liver and kidney transplant recipients,and to compare the effectiveness of the two models in assessing postoperative cardiovascular events in transplant populations.Methods:1.Selection of research objects and data collection: collect the in-patient or outpatient follow-up data of liver and kidney transplant recipients in Kunming First People’s Hospital from 2006 to 2022,consult and record the occurrence of cardiac,cerebrovascular and peripheral vascular events and laboratory indicators of related event risk factors through the hospital information management platform,and make statistics and analysis of postoperative hypertension,diabetes The prevalence of risk factors such as hyperlipidemia and the distribution of related factors in the CVE and non CVE groups;2.Use commonly used cardiovascular and cerebrovascular risk assessment models at home and abroad to assess the related risks of liver and kidney transplant recipients after surgery,and statistically analyze the prevalence of risk stratification of CVE events to determine whether the corresponding cardiovascular and cerebrovascular risk assessment models are suitable for the transplant population;3.Statistical method: IBM SPSS Statistics 26.0 statistical software package wasused for statistical analysis to compare the distribution of cardiovascular and cerebrovascular risk factors among liver and kidney transplant recipients in each group.Spearman rank correlation analysis was used to analyze the correlation between corresponding risk factors and experimental indicators and the occurrence of CVE events.Logistic multivariate regression analysis is used to analyze the role of various risk factors in CVE events.Chi-square test was used to analyze the risk stratification component ratio of cardiovascular and cerebrovascular events between the CVE group and the non CVE group,to explore whether the relevant model is suitable for the transplant population.The effectiveness of the "Framingham Risk Assessment Model" and "Chinese Ischemic Cardiovascular Disease(ICVD)Risk Assessment Model" was evaluated using the receiveroperating characteristic curve(ROC).Results:1.A total of 129 liver and kidney transplant recipients were included in this study,of which 11 were excluded due to missing data and loss of follow-up.Finally,case data and laboratory examination data were collected from 118 liver and kidney transplant recipients in our hospital,with an average age of 46.85 ± 7.41 years old and an average follow-up period of 3.75(2.00,7.00)years.Among them,84 were male recipients and 34 were female recipients;There were 32 liver transplant recipients and86 kidney transplant recipients.After transplantation,12 recipients had cardiovascular and cerebrovascular events(10.17%),including 7 cardiovascular events(coronary syndrome)(58.3%),3 cerebrovascular events(ischemic stroke,hemorrhagic stroke),and 2 peripheral vascular events(arterial/venous thrombosis).2.Analysis of risk factors related to cardiovascular and cerebrovascular events:63patients with hypertension,with an incidence of 53.4%;There were 16 patients with diabetes(13.6%),and 75 patients with hyperlipidemia(63.6%);Among them,there were 56 patients with hypertriglyceridemia,12 patients with hypercholesterolemia,and 7 patients with mixed hyperlipidemia.3.Comparison of the effectiveness of the two research models in assessing cardiovascular and cerebrovascular events: The risk stratification constituent ratios of the CVE group and the non CVE group were statistically significant in both models(P<0.05),and the average predictive risk value of the CVE group was significantly higher than that of the non CVE group(P<0.05);The ROC curve analysis showed that the AUC values of the two study models were 0.787 and 0.743,respectively,which were greater than the screening threshold of 0.5,with a statistically significant difference(P<0.05).Both study models can be used to assess the risk of cardiovascular and cerebrovascular events in liver and kidney transplant populations within 10 years.Conclusions:1.Risk factors related to cardiovascular and cerebrovascular events after transplantation are common among recipients,and the frequency of occurrence is hyperlipidemia,hypertension,diabetes,etc.2.Both the "Framingham Risk Assessment Model" and the "Chinese Ischemic Cardiovascular Disease(ICVD)Risk Assessment Model" can be used to predictthe risk of cardiovascular and cerebrovascular events in liver and kidney transplant recipients,and the "Framingham Risk Assessment Model" has a better evaluation effect.