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the risk of CAV in subjects treated with CNI/AZA (HR-2.33, CI -1.06-5.0, p 0.035; n 160) but not in CNI/MMF (HR -1.49, CI 0.26-7.71, p 0.64; n 59) or in sirolimus (as primary immunosuppressant) treated subjects (HR 0.13, CI 0.001-2.55, p 0.13, n 33). In multivariate analysis 6-month TRS (HR 2.84, CI1.44-6.91, p 0.02) and 6-month MRS (HR-2.66, CI-0.99-6.95, p 0.05) remained significant predictors of increased risk for CAV onset. Twelve and 24 months rejection scores were not risk factors for the onset of CAV. By Kaplan-Meier analysis 6month TRS 0.3 was associated with a significantly shorter time to CAV onset (p 0.018). There was no association between TRS and MRS and 3D IVUS criteria but 38% of this group were treated with sirolimus and 69% with MMF. Conclusions: Increased episodes of rejection in the first 6 months in subjects treated with CNI and AZA increases risk of CAV. Lack of association between rejection score and CAV, assessed agiographically and by 3D IVUS in patients treated with MMF and sirolimus suggests that this combination of immunosuppressive agents may result in improvement in the long-term outcome of CAV.