| Advancing immunosuppression therapy to counter the progression of cardiac allograft vasculopathy. | |
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MedLine Citation:
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PMID: 15732035 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Osama El-Sayed; Raymond D Magorien; Anthony Orsini; Amy K Ferketich; Carl V Leier |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of cardiac failure Volume: 11 ISSN: 1071-9164 ISO Abbreviation: J. Card. Fail. Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-25 Completed Date: 2005-07-11 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9442138 Medline TA: J Card Fail Country: United States |
Other Details:
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Languages: eng Pagination: 137-41 Citation Subset: IM |
Affiliation:
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Division of Cardiology, The Ohio State University Medical Center, Columbus, Ohio 43210, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Azathioprine
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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:
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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
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