Evolution of Biomarkers of Atherogenic Risk in Liver Transplantation Recipients

• Published in: Transplantation proceedings Vol. 50; no. 10; pp. 3650 - 3655
• Main Authors: Linhares, L.M.C., Oliveira, C.P., Alvares-da-Silva, M.R., Stefano, J.T., Barbeiro, H.V., Barbeiro, D.F., Terrabuio, D.R.B., Abdala, E., Soriano, F.G., Carrilho, F.J., Farias, A.Q., Siddiqui, M.S., D'Albuquerque, L.A.C.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2018
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2018.04.030

Cardiovascular disease is a major contributing factor to long-term mortality after liver transplantation (LT).
This study evaluated the evolution of atherogenic risk in liver transplant recipients (LTRs). Thirty-six subjects were prospectively enrolled at 12 months and followed for 48 months after liver transplantation. Serum biomarkers of endothelial dysfunction (sICAM-1 and sVCAM-1), chronic inflammation (serum amyloid A), and oxidative stress (myeloperoxidase) were measured at 12 and 48 months after LT. Additionally, at 12 months all patients underwent a cardiac computed tomography (CT) scan and a coronary artery calcium score (CACS).
The prevalence of risk factors of metabolic syndrome (MS) increased over the course of the study. The patients' sVCAM-1 and sICAM-1 increased from 1.82 ± 0.44 ng/mL to 9.10 ± 5.82 ng/mL (P < .001) and 0.23 ± 0.09 ng/mL to 2.7 ± 3.3 ng/mL, respectively from month 12 to 48. Serum myeloperoxidase increased from 0.09 ± 0.07 ng/mL to 3.46 ± 3.92 ng/mL (P < .001) over the course of the study. Serum amyloid A also increased from 21.4 ± 40.7 ng/mL at entry to 91.5 ± 143.6 ng/mL at end of study (P < .001).
No association between these biomarkers and MS was noted. The cardiac CT revealed mild and moderate disease in 19% and 25% of the cohort, respectively. No association between serum biomarkers and CACS was noted. Serum biomarkers of atherogenic risk increase rapidly in LTRs and precede coronary plaques.
•Advances in both therapeutic and surgical techniques have transformed the long-term survival rates of liver transplant recipients.•Medical complications arise from longer survival rates, including cardiovascular (CV) disease, resulting in greater incidences of late morbidity and mortality.•We evaluated cardiovascular risk (CVR) and cardiovascular events in 40 consecutive adult patients in the first and fourth years after liver transplant.•For the first time we have evaluated serum biomarkers of atherosclerosis and coronary artery calcium scores.