| Outcomes of bare metal versus drug-eluting stents in allograft vasculopathy. | |
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MedLine Citation:
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PMID: 18971095 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Because of improved outcomes with drug-eluting stents (DES), we examined angiographic and clinical outcomes of bare metal stents (BMS) vs DES for discrete lesions in chronic allograft vasculopathy. METHODS: Heart transplant patients who underwent percutaneous coronary intervention were divided into one of two groups: BMS or DES. Baseline clinical characteristics, rejection episodes and procedural details were compared. Distal arteriopathy was qualitatively compared using the Gao score. End-points included angiographic in-stent restenosis, acute coronary syndrome (ACS), ST-elevation myocardial infarction, heart failure admissions and cardiac death at 1 year. Student's t-test, chi-square test and the Mann-Whitney U-test were utilized to assess the results. Correlations were assessed using Pearson's correlation coefficient. RESULTS: Forty-two patients with 80 stents (56 DES, 24 BMS) were identified. Baseline clinical characteristics, immunosuppression regimen, cardiac risk factors, frequency of rejection and procedural details were similar. Distal arteriopathy was similar (p = 0.374), suggesting equally advanced vasculopathy. Twenty-nine patients (69%) and 46 lesions (58%) were available at 1 year for clinical and angiographic follow-up. One-year diameter stenosis (26.1 +/- 21.3% vs 31.7 +/- 38.3%; p = 0.602) and binary restenosis (22.6% vs 22.7%; p = 0.774) rates were similar for DES and BMS, respectively. There were no ST-elevation infarctions; ACS [9 (16%) vs 5 (21%) p = 0.638] and cardiac death (2 in both groups) were similar for DES and BMS, respectively. Heart failure admissions were more frequent in the DES group [18 (32%) vs 5 (21%); p = 0.016]. No clinical predictors were identified. CONCLUSIONS: In-stent stenosis, ACS and cardiac death at 1 year were similar for DES and BMS. The milieu of systemic immunosuppression in heart transplant decreases the advantages of DES in allograft vasculopathy. |
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Authors:
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Proddutur R Reddy; Akhil Gulati; Lowell Steen; James Sinacore; Ferdinand Leya; Alain Heroux |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation Volume: 27 ISSN: 1557-3117 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2008 Nov |
Date Detail:
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Created Date: 2008-10-30 Completed Date: 2009-02-13 Revised Date: 2009-05-06 |
Medline Journal Info:
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Nlm Unique ID: 9102703 Medline TA: J Heart Lung Transplant Country: United States |
Other Details:
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Languages: eng Pagination: 1222-8 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Loyola University Medical Center, Maywood, Illinois, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angioplasty, Transluminal, Percutaneous Coronary Coronary Restenosis / epidemiology*, mortality Drug-Eluting Stents* Equipment Design Heart Catheterization Heart Failure / epidemiology Heart Transplantation / adverse effects* Humans Postoperative Complications / surgery Stents* Transplantation, Homologous Treatment Outcome |
| Comments/Corrections | |
Comment In:
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J Heart Lung Transplant. 2009 May;28(5):531
[PMID:
19416788
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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