Class 1 Indications for Coronary Revascularization Identified in Prekidney Transplant Screening.

Many transplant programs mandate routine coronary artery disease screening.

许多移植项目要求常规进行冠状动脉疾病筛查。

It remains unclear how many patients meet class 1 indication for revascularization.

目前尚不清楚有多少患者符合血管重建的1级指征。

We conducted a meta-analysisto estimate the prevalence.

我们进行了一项荟萃分析，以估计患病率。

Despite high frequency of screening, we found a relatively low prevalenceof class 1 indication for coronary revascularization.

尽管筛查频率高，但我们发现冠状动脉血运重建的1类指征的患病率相对较低。

Background

Cardiovascular disease is the most common cause of morbidity and mortality in kidney transplant recipients.

心血管疾病是肾移植受者发病率和死亡率的最常见原因。

Screening for coronary disease is frequently required before kidney transplantation, but coronary intervention has not been shown to be beneficial except in complex coronary artery disease.

在肾脏移植前，经常需要进行冠状动脉疾病筛查，但除非是复杂的冠状动脉疾病，否则冠状动脉干预并未显示出有益效果。

The likelihood of finding significant coronary artery disease and the benefits of routine pretransplant screening are uncertain.

发现显著冠状动脉疾病的概率以及常规移植前筛查的益处是不确定的。

Methods

We performed a systematic reviewand meta-analysis.

我们进行了一项系统评价和荟萃分析。

Medical Literature Analysis and Retrieval System Online and Excerpta Medica database were searched to identify manuscripts published between 1998 and 2024 reporting the results of pretransplant screening.

我们搜索了医学文献分析和检索系统在线（MEDLINE）和医学文摘数据库（EMBASE），以确定1998年至2024年间发表的报告移植前筛查结果的手稿。

The primary end points were the frequency of detecting significant coronary lesions for which there are American Heart Association class 1 indications for revascularization: ( 1 ) >50% left main stenosis or ( 2 ) multivessel disease with ejection fraction <35% during prekidney transplant screening.

主要终点是检测到有美国心脏协会I类指征进行血运重建的显著冠状动脉病变的频率：（1）>50%的左主干狭窄或（2）移植前筛查期间射血分数<35%的多血管病变。

Secondary end points included frequency of detecting multivessel disease, proximal left anterior descending artery disease, and number of patients who underwent invasive coronary angiography.

次要终点包括检测到多血管病变的频率、近端左前降支病变的频率，以及接受侵入性冠状动脉造影的患者数量。

Meta-regression was used to explore outcome heterogeneity according to the presence of hypertension, diabetes, and age.

我们使用元回归分析来探究高血压、糖尿病和年龄存在与否对结果异质性的影响。

Results

We identified 1273 studies, out of which 44 met eligibility criteria.

我们确定了1273项研究，其中44项符合资格标准。

The mean prevalenceof class 1 indications was 2%, although the heterogeneity was high with estimates ranging from 0% to 17%.

I类指征的平均患病率为2%，尽管异质性很高，估计值范围从0%到17%。

Estimated prevalenceof proximal left anterior descending disease was 2% and left main stenosis was 1%, whereas 10% of patients had multivessel coronary artery disease, and 35% were referred for invasive angiography.

近端左前降支疾病的发生率为2%，左主干狭窄的发生率为1%，而10%的患者有多支冠状动脉疾病，35%的患者被推荐进行侵入性血管造影。

There was no evidence of significant heterogeneity according to sex of the population or prevalenceof diabetes or hypertension.

根据人群性别或糖尿病或高血压的患病率，没有证据表明存在显著的异质性。

Conclusions

Identification of class 1 indications for revascularization during pretransplant coronary screening was rare.

在移植前冠状动脉筛查中识别出的再血管化1级指征很少见。

podcast

This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN/2026_01_08_ASN0000000890.mp3.

本文包含一个播客，可在 https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/JASN/2026_01_08_ASN0000000890.mp3. 收听。