Innovative Risk Score Predicts Heart Attack or Stroke in Kidney Transplant Candidates

Heart researchers have utilized an innovative risk assessment score to accurately predict whether patients being evaluated for kidney transplants are at risk for future major cardiac events, such as a heart attack or stroke.

Clinicians at Intermountain Health (Salt Lake City, UT, USA) regularly analyze patient data through their electronic health system to identify individuals who may have heart disease without knowing it. The Intermountain Risk Score (IMRS) is a well-established, sex-specific tool that predicts the risk of major cardiovascular events and death, using factors such as age and results from complete blood count and basic metabolic profile testing. These scores are automatically calculated based on data entered into the electronic health records. If a patient's score is high, their care team is alerted. In a significant new study, the researchers discovered that the IMRS could also predict whether patients being assessed for kidney transplant would experience a major cardiac event, such as a heart attack or stroke.

The study focused on evaluating the IMRS's accuracy in predicting cardiac events in patients considered for kidney transplant. The researchers identified 891 patients who were assessed for transplant surgery at Intermountain Health between June 2015 and April 2024. Of these, 200 patients lacked the necessary laboratory tests to calculate an IMRS, so they were excluded from further analysis. This left 691 patients with sufficient data to calculate their IMRS. The average age of these patients was 55.9 years, and 34.3% were women. Over a five-year follow-up period, 171 of the 691 patients experienced a major cardiac event.

The researchers found that the IMRS was effective in predicting these outcomes, highlighting the potential of using such a score in patients being evaluated for kidney transplant. However, approximately 200 individuals in the study were excluded due to insufficient laboratory data. The next steps involve validating the risk score in another patient population, exploring whether adding routinely collected kidney patient data to the score improves its predictive ability, and conducting a prospective clinical trial to determine if using the score to guide clinical care improves patient outcomes.

“This study demonstrates that we could adapt our already existing risk score guide to help identify which of these patients might also be at risk for having a heart event, which could lead to better and more personalized treatment,” said Benjamin Horne, PhD, director of cardiovascular and genetic epidemiology at the Intermountain Health.

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