Document Detail


Advancing immunosuppression therapy to counter the progression of cardiac allograft vasculopathy.
MedLine Citation:
PMID:  15732035     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiac allograft vasculopathy (CAV) is the major cause of late mortality in heart transplant recipients. Because immunosuppressive therapy has been convincingly shown to suppress cellular rejection and prolong cardiac allograft survival, we assessed the efficacy of advancing immunosuppressive therapy in reversing or delaying CAV by switching azathioprine to combination mycophenolate mofetil and prednisone (MMF-P). METHODS AND RESULTS: Seventeen adult posttransplant patients, whose CAV was prospectively approached with the MMF-P protocol, were studied. The development of significant CAV was declared on the index coronary angiogram and the MMF-P protocol was instituted. The degree of occlusion for all coronary lesions was quantitated for the index angiogram, and for the angiograms performed 1 year before (baseline) the index angiogram and annually for 2 years after the index angiogram (MMF-P years 1 and 2). There was a significant change in percent occlusion over time (P < .001). Percent occlusion increased significantly from the baseline year to the index CAV year, but then decreased significantly from the index CAV year to the MMF-P treatment years 1 and 2. CONCLUSION: Advancing immunosuppression with MMF-P can delay the progression of and partially reverse lumen narrowing of CAV in heart transplant recipients.
Authors:
Osama El-Sayed; Raymond D Magorien; Anthony Orsini; Amy K Ferketich; Carl V Leier
Related Documents :
20516505 - Target lesion revascularization after bare-metal or drug-eluting stents: clinical prese...
7930235 - Coronary stenting for acute coronary dissection after coronary angioplasty: implication...
18580055 - Incidental atherosclerotic renal artery stenosis diagnosed at cardiac catheterization: ...
17069905 - High sensitive c-reactive protein and interleukin 6 are not related to neointimal hyper...
22080925 - Cardiac allograft vasculopathy.
22079515 - Dodecafluoropentane emulsion decreases infarct volume in a rabbit ischemic stroke model.
Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiac failure     Volume:  11     ISSN:  1071-9164     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-25     Completed Date:  2005-07-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  137-41     Citation Subset:  IM    
Affiliation:
Division of Cardiology, The Ohio State University Medical Center, Columbus, Ohio 43210, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Azathioprine / therapeutic use
Coronary Angiography
Coronary Disease / immunology,  prevention & control*
Cyclosporine / therapeutic use
Drug Therapy, Combination
Female
Heart Transplantation*
Humans
Immunosuppression*
Immunosuppressive Agents / therapeutic use*
Male
Middle Aged
Mycophenolic Acid / analogs & derivatives*,  therapeutic use*
Postoperative Complications / immunology,  prevention & control*
Prednisone / therapeutic use*
Prospective Studies
Chemical
Reg. No./Substance:
0/Immunosuppressive Agents; 128794-94-5/mycophenolate mofetil; 24280-93-1/Mycophenolic Acid; 446-86-6/Azathioprine; 53-03-2/Prednisone; 59865-13-3/Cyclosporine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Plasma monitoring of the myocardial specific tissue inhibitor of metalloproteinase-4 after alcohol s...
Next Document:  Partial support with a centrifugal left ventricular assist device reduces myocardial oxygen consumpt...