| Influence of Steroid Dosage, Withdrawal, and Reinstatement on Survival After Heart Transplantation: Results From the RESTCO Study. | |
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MedLine Citation:
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PMID: 23146492 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: Little information is available regarding the consequences of steroid withdrawal following heart transplantation (HT) in Spain. METHODS: We analyzed the records of 1068 patients (81.6% men) who underwent HT between 2000 and 2005 in 13 Spanish centers who were aged ≥ 18 years and who survived at least 1 year. Death rates and Kaplan-Meier survival curves for 1 to 5 years post-HT were compared among four groups: groups A and B, patients on steroids throughout the first 5 years post-HT at dosages of ≤5 mg/d between 1-year and 5-year follow-up (group A; n = 148), or >5 mg/d for some part of this period (group B; n = 578). Groups C and D were patients from whom steroids were at some point withdrawn including group D (n = 73) with and group C (n = 269) without subsequent reintroduction into the maintenance regimen. RESULTS: Steroids were withdrawn at 1.6 ± 0.9 years post-HT in group C, and 1.7 ± 1.2 years post-HT in group D. The death rate between 1- and 5-year follow-up (deaths per 1000 person-years) was 44.3% (95% confidence interval 26.2-62.5) in group A, 42.6% (33.7-51.4) in group B, 30.5% (19.6-41.4) in group C, and 47.8% (21.8-73.7) in group D. There was no significant difference among them or among Kaplan-Meier survival curves of the four groups (P = .34 in both cases). Comparison of combined groups C + D with groups A + B showed no evidence of a greater mortality among combined groups C + D. CONCLUSIONS: The late withdrawal of steroids following HT was not associated with increased mortality. |
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Authors:
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J Delgado Jiménez; L Almenar Bonet; M J Paniagua Martín; M Gómez Bueno; J F Yáñez; J M Arizón Del Prado; T Blasco Peiró; L de la Fuente Galán; I P Garrido Bravo; M G Crespo-Leiro |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Transplantation proceedings Volume: 44 ISSN: 1873-2623 ISO Abbreviation: Transplant. Proc. Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-13 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0243532 Medline TA: Transplant Proc Country: United States |
Other Details:
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Languages: eng Pagination: 2679-81 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Hospital Universitario 12 de Octubre, Madrid, Spain. Electronic address: jdelgado.hdoc@salud.madrid.org. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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