| Prognosis of moderate coronary artery lesions in heart transplant patients. | |
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MedLine Citation:
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PMID: 12581760 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Despite recent advances in our understanding of allograft vasculopathy, little is known about the evolution of moderate coronary lesions in heart transplant recipients. METHODS: We retrospectively analyzed 58 heart transplant patients undergoing annual coronary angiography who demonstrated a moderate lesion (>30% and <60% diameter stenosis) on any routine annual study. In an attempt to find criteria that could distinguish such patients who were at high risk of disease progression from those at low risk, we reviewed the clinical and biologic features and angiographic and clinical outcomes of patients with and without lesion progression at 1 year. RESULTS: Of the 58 patients who had an initially moderate coronary lesion, 28 (48%) showed progression of the lesion at angiography 1 year later (occlusion of the culprit vessel or progression to a severe lesion >60%) that required revascularization (angioplasty or bypass surgery). The 30 remaining patients showed no lesion progression. At the time of the first angiogram the only criterion which could predict lesion progression at 1 year was the presence of multi-vessel disease (p < 0.0001). Prognosis for these patients was poorer than in those with no disease progression, with a higher proportion of revascularization and sudden death (p < 0.001). Patients without lesion progression at 1 year had neither clinical events nor significant subsequent lesion progression during a mean follow-up of 6 years. CONCLUSIONS: The presence of a moderate coronary stenosis in heart transplant patients justifies a repeat angiogram 1 year later. The use of percutaneous coronary angioplasty in such patients has not been validated, but may be an option to delay or prevent progression to coronary occlusion. |
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Authors:
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Charles Edouard Luyt; Gérard Drobinski; Richard Dorent; Jean-Jacques Ghossoub; Jean-Philippe Collet; Rémi Choussat; Miles Dalby; Daniel Thomas; Iradj Gandjbakhch |
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: 22 ISSN: 1053-2498 ISO Abbreviation: J. Heart Lung Transplant. Publication Date: 2003 Feb |
Date Detail:
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Created Date: 2003-02-12 Completed Date: 2003-08-29 Revised Date: 2004-11-17 |
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: 130-6 Citation Subset: IM |
Affiliation:
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Cardiology, Pitié-Salpétrière Hospital, Paris, France. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Case-Control Studies Coronary Angiography Coronary Stenosis / epidemiology*, etiology, radiography Disease Progression Follow-Up Studies Heart Transplantation* Humans Immunosuppressive Agents / therapeutic use Middle Aged Prognosis Retrospective Studies Time Factors |
| Chemical | |
Reg. No./Substance:
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0/Immunosuppressive Agents |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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