{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T15:13:15Z","timestamp":1761664395177,"version":"3.40.5"},"reference-count":30,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T00:00:00Z","timestamp":1647388800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Cardiovascular disease (CVD) is a major cause of morbidity and mortality after liver transplantation, mostly in patients transplanted for nonalcoholic steatohepatitis, obesity and diabetes. Few data exist on cardiovascular diseases among patients transplanted for viral hepatitis.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Objective<\/jats:title>\n<jats:p>Our aim is to clarify the cardiovascular risk and subclinical vascular damage among liver transplant recipients for chronic viral hepatitis (i.e. hepatits C virus, hepatis B virus and hepatitis D virus infection).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Adult patients (age \u2265 18 years) with orthotopic liver transplants (OLT) due to viral hepatitis who signed informed consent, and were admitted for a routine follow-up between June 2019 and September 2020 at the Infectious Disease outpatient clinic of the University of Campania Luigi Vanvitelli, Naples, Italy, were prospectively enrolled. An estimation of cardiovascular risk was assessed using three main risk charts, echocolor-Doppler of epiaortic vessels was performed to assess subclinical Intima-Media changes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 161 patients were evaluated; of these 15 were excluded because not affected by viral hepatitis. 146 patients were considered. 83 patients (56.8%) were considered at high cardiovascular risk according to Framingham, 54 patients (36.9%) to American Heart Association Arteriosclerotic Cardiovascular Disease (ASCVD) score and 19 (13.0%) to Heart Score. Only 8 patients (5.4%) showed a normal carotid ultrasound, while 52 patients (35.6%) had a carotid artery Intima-Media Thickness (IMT) and 86 (58.9%) an atherosclerotic plaque.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>Liver transplant recipients for virus-related associated liver disease are, in light of the high percentage of carotid lesions, at high risk of CVD. Risk charts compared to subclinical carotid lesions which represent damage already established and a real localization of the disease, seem to underestimate the cardiovascular risk. A chronic inflammatory status, could play a key role. It\u2019s important to raise the awareness of cardiovascular risk in liver transplant patients to prevent cardiovascular diseases and improve the timing of early diagnosis of premature vascular lesions.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0265178","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T17:37:15Z","timestamp":1647452235000},"page":"e0265178","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Cardiovascular disease risk in liver transplant recipients transplanted due to chronic viral hepatitis"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8772-0136","authenticated-orcid":true,"given":"Paolo","family":"Maggi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Cal\u00f2","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincenzo","family":"Messina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianfranca","family":"Stornaiuolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Stanzione","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Rinaldi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"De Pascalis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margherita","family":"Macera","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Coppola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2022,3,16]]},"reference":[{"key":"pone.0265178.ref001","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1007\/s00508-016-1046-1","article-title":"Indications for liver transplantation in adults: Recommendations of the Austrian Society for Gastroenterology and Hepatology (\u00d6GGH) in cooperation with the Austrian Society for Transplantation, Transfusion and Genetics (ATX)","volume":"128","author":"I Graziadei","year":"2016","journal-title":"Wien Klin Wochenschr"},{"key":"pone.0265178.ref002","doi-asserted-by":"crossref","first-page":"1193","DOI":"10.1111\/liv.13371","article-title":"Mortality from liver cirrhosis and hepatocellular carcinoma in western Europe over the last 40 years","volume":"37","author":"A Ascione","year":"2017","journal-title":"Liver Int"},{"key":"pone.0265178.ref003","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s12967-019-2033-x","article-title":"Incidence and risk factors of early HCC occurrence in HCV patients treated with direct acting antivirals: a prospective multicentre study","volume":"17","author":"L Rinaldi","year":"2019","journal-title":"J Transl Med"},{"issue":"6","key":"pone.0265178.ref004","doi-asserted-by":"crossref","first-page":"E1351","DOI":"10.3390\/cancers12061351","article-title":"Risk of Hepatocellular Carcinoma after HCV Clearance by Direct-Acting Antivirals Treatment Predictive Factors and Role of Epigenetics","volume":"12","author":"L Rinaldi","year":"2020","journal-title":"Cancers (Basel)"},{"issue":"2","key":"pone.0265178.ref005","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/S1665-2681(19)32022-8","article-title":"Post-liver transplantation medical complications","volume":"5","author":"R Moreno","year":"2006","journal-title":"Annals of Hepatology"},{"key":"pone.0265178.ref006","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1016\/j.ejim.2018.11.003","article-title":"Mortality rate and risk factors for gastrointestinal bleeding in elderly patients","volume":"61","author":"REPOSI Investigators","year":"2019","journal-title":"Eur J Int Med"},{"key":"pone.0265178.ref007","doi-asserted-by":"crossref","first-page":"e41162","DOI":"10.5812\/hepatmon.41162","article-title":"Serial liver stiffness measurements and monitoring of liver-transplanted patients in a real-rife clinical practice","volume":"16","author":"L Rinaldi","year":"2016","journal-title":"Hepat Mon"},{"key":"pone.0265178.ref008","doi-asserted-by":"crossref","first-page":"489","DOI":"10.3390\/medicina55080489","article-title":"Cardiovascular and Metabolic Consequences of Liver Transplantation: A Review","volume":"55","author":"O Plotogea","year":"2019","journal-title":"Medicina (Kaunas)"},{"key":"pone.0265178.ref009","doi-asserted-by":"crossref","first-page":"1140","DOI":"10.1002\/lt.23508","article-title":"Is liver transplantation a risk factor for cardiovascular disease? 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