Document Detail


Prevalence of donor-transmitted coronary artery disease and its influence on heart transplant outcomes.
MedLine Citation:
PMID:  20970589     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: It is uncertain whether donor-transmitted coronary artery disease (DTCAD) affects heart transplant (HT) recipients.
METHODS: This retrospective analysis includes records of all patients who underwent a HT at our center over an 8-year period, who survived for at least 1 month, and who were examined by coronary angiography within 2 months post-HT. We distinguished angiographically from keep ultrasonography (IVUS) detected DTCAD. Major adverse cardiovascular events (MACE) comprised death, myocardial infarction, unstable angina, coronary revascularization, and admission because of heart failure not due to an acute rejection episode.
RESULTS: Among the 171 patients of mean age 53±13 years and including 83% men, 65 (38%) were evaluated by IVUS. Donors were aged 40±14 years (range=14-73). Angiographic DTCAD affected seven patients (4.1%), and IVUS-detected DTCAD, 35 (53.8% of those examined by IVUS). DTCAD donors were older than non-DTCAD donors, by an average of 13 years (P=.001) for angiographic DTCAD and 18 years (P<.0001) for IVUS-detected DTCAD. Two patients underwent percutaneous revascularization upon detection of angiographic DTCAD. The angiographic- and IVUS-detected DTCAD groups did not differ significantly from the corresponding non-DTCAD groups as regards MACE incidence during 54±41 and 38±20 months follow-up, respectively. Cox regression analysis with adjustment for relevant confounders confirmed that IVUS-detected DTCAD was not a predictor of MACE (hazard ratio 1.2, 95% confidence interval 0.2-8.1).
CONCLUSIONS: Among HT patients surviving≥1 month, angiographic- and IVUS-detected DTCAD showed prevalences of <10% and >50%, respectively. Neither detection method was associated with a greater long-term incidence of MACE.
Authors:
R Estevez-Loureiro; M J Paniagua-Martin; R Calviño-Santos; J M Vazquez-Rodríguez; J Salgado-Fernandez; R Marzoa-Rivas; E Barge-Caballero; Z Grille; A Pérez-Pérez; J A Rodríguez-Fernandez; N Vázquez-González; J J Cuenca-Castillo; A Castro-Beiras; M G Crespo-Leiro
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Transplantation proceedings     Volume:  42     ISSN:  1873-2623     ISO Abbreviation:  Transplant. Proc.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-10-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0243532     Medline TA:  Transplant Proc     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2987-91     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Elsevier Inc. All rights reserved.
Affiliation:
Heart Transplant and Advanced Heart Failure Unit, Division of Cardiology, Hospital Universitario A Coruña, La Coruña, Spain. Rodrigo.Estevez.Loureiro@sergas.es
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