Document Detail

Prognosis of moderate coronary artery lesions in heart transplant patients.
MedLine Citation:
PMID:  12581760     Owner:  NLM     Status:  MEDLINE    
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.
Charles Edouard Luyt; Gérard Drobinski; Richard Dorent; Jean-Jacques Ghossoub; Jean-Philippe Collet; Rémi Choussat; Miles Dalby; Daniel Thomas; Iradj Gandjbakhch
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:  22     ISSN:  1053-2498     ISO Abbreviation:  J. Heart Lung Transplant.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-12     Completed Date:  2003-08-29     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:  130-6     Citation Subset:  IM    
Cardiology, Pitié-Salpétrière Hospital, Paris, France.
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MeSH Terms
Case-Control Studies
Coronary Angiography
Coronary Stenosis / epidemiology*,  etiology,  radiography
Disease Progression
Follow-Up Studies
Heart Transplantation*
Immunosuppressive Agents / therapeutic use
Middle Aged
Retrospective Studies
Time Factors
Reg. No./Substance:
0/Immunosuppressive Agents

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