Document Detail


Does rapidity of development of transplant coronary artery disease portend a worse prognosis?
MedLine Citation:
PMID:  7865519     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We postulated that transplant coronary artery disease with rapid progression to more than 50% stenosis within a 1-year interval may have a different prognosis from transplant coronary artery disease with a more indolent rate of progression. Annual coronary angiograms of 139 consecutive patients who underwent transplantation between January 1968 and February 1990 who survived at least 1 year after transplantation and in whom angiographically apparent transplant coronary artery disease developed were included in the study. Of this group, 45 patients progressed from a normal angiogram to the presence of 50% or greater stenosis in one or more major vessels within 1 year (fulminant group); 94 did not (indolent group). Mean posttransplantation follow-up time was 5.3 +/- 4.1 years for patients with fulminant progression of disease and 6.6 +/- 3.7 years for those with indolent progression. A highly significant difference was found in the time-related incidence of ischemic events (myocardial infarction, congestive heart failure, sudden death, and retransplantation) between the indolent and the fulminant groups after initial detection of transplant coronary artery disease. At 1, 3, and 5 years after initial detection of transplant coronary artery disease, 50%, 33%, and 16% of patients in the fulminant group and 89%, 70%, and 60% of patients in the indolent group were free of ischemic events (p < 0.0001). The fulminant group of patients had a mean of 2.9 +/- 1.5 rejection episodes, and the indolent group a mean of 2.3 +/- 1.4 episodes (p = 0.02) during the first year after transplantation.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
S Z Gao; S A Hunt; J S Schroeder; E Alderman; I R Hill; E B Stinson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation     Volume:  13     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:    1994 Nov-Dec
Date Detail:
Created Date:  1995-03-28     Completed Date:  1995-03-28     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  9102703     Medline TA:  J Heart Lung Transplant     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1119-24     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, CVRC, Stanford University School of Medicine, CA 94305.
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MeSH Terms
Descriptor/Qualifier:
Adult
Coronary Angiography
Coronary Disease / etiology*,  radiography
Female
Heart Transplantation / adverse effects*
Humans
Male
Prognosis
Risk Factors
Time Factors

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


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