SAT-785 Predictors Of Osteoporosis In Orthotopic Heart Transplant Recipients

Abstract Disclosure: A. Safdar: None. A. Saji: None. R. Tijerina: None. E. Cherian: None. C. Green: None. Y. Zhang: None. P.R. Orlander: None. Osteoporosis is commonly found after heart transplantation (HT) and predisposes to increased risk of osteoporotic fractures particularly during the first year of transplant (1). Various risk factors including advancing age, osteopenia/osteoporosis prior to transplant, chronic kidney disease, immunosuppressive therapy including use of steroids and calcineurin inhibitors, and low BMI, increase the risk for osteoporosic fracture (1). Bone mineral density (BMD) using DEXA is the most common mode of surveillance. We sought to describe the changes in BMD, and other predictors of osteoporosis, as well as incidence of osteoporosis in a single center cohort over a 5 year period in 315 consecutive patients. Mean age of our patient population was 63.5 years (range 26-85 years) with 70 % being male. Two different models including Bayesian and frequentist model were used to understand the predictors of osteoporosis using femur T-scores in HT patients. In both models, age was significantly negatively associated with femur T-scores (p < 0.0001) while for continuous BMI, there was a significant positive association with femur T-scores (p < 0.0001). While in the frequentist model, creatinine was not significantly associated with T-scores (p = 0.0895 > 0.05), in the Bayesian model, it was significantly positively associated with T-scores (posterior probability = 0.9547 > 0.95). 25(OH) Vitamin D was significantly negatively associated with femur T-scores, with each one-unit increase in 25(OH)D corresponding to a 0.013-unit decrease in T-score. Compared to patients without osteoporosis before the transplant, those with osteoporosis prior to transplant could have T-scores that are 1.27 units lower, indicating a greater fracture risk. Diabetes (p = 0.3450), hypertension (p = 0.5620), hyperlipidemia (HLD) (p = 0.3500), and kidney disease (p = 0.6210) prior to heart transplant were not significantly associated with T-scores. When controlling for other factors, gender (p = 0.702), smoking status and alcohol consumption did not significantly affect femur T- scores. The knowledge of various factors predicting osteoporosis risk in HT patients, can help us identify and treat patients at early stages and contribute to preventing osteoporotic fractures in this patient population. References: Forien M, Coralli R, Verdonk C, et al. Osteoporosis and risk of fracture in heart transplant patients. Front Endocrinol (Lausanne). 2023 Sep 13;14:1252966. doi: 10.3389/fendo.2023.1252966. Presentation: Saturday, July 12, 2025