Back to Search
Start Over
Persistent mild lesions in coronary angiography predict poor long-term survival of heart transplant recipients.
- Source :
-
The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation [J Heart Lung Transplant] 2014 Jun; Vol. 33 (6), pp. 618-23. Date of Electronic Publication: 2013 Oct 25. - Publication Year :
- 2014
-
Abstract
- Background: Even though coronary angiography (CAG) underestimates coronary allograft vasculopathy (CAV) development, especially in the distal parts of arteries, it remains a frame of reference for International Society for Heart and Lung Transplantation (ISHLT) CAV classification. A retrospective analysis was performed to assess the prognostic value of CAG findings.<br />Methods: Among 310 orthotopic heart transplantation (OHT) recipients with at least 2 CAGs at 2-year intervals, we identified 197 (146 men and 41 women; 55 ± 13 years) without lesions (Group 0), 27 (15 men and 12 women; 58 ± 8 years) in whom mild changes remained in consecutive CAGs (Group 1), 28 (24 men and 4 women; 58 ± 10 years) in whom mild lesions decreased in consecutive CAGs (Group 1REG), and 58 (53 men and 5 women; 56 ± 10 years) in whom the stenosis criteria of ISHLT CAV 2 or 3 were covered (Group 2). We compared survival and other clinical variables among the groups.<br />Results: The average follow-up was 10 ± 4 years. Forty-one (21%) deaths occurred in Group 0, 15 (56%) in Group 1 (p = 0.002), 9(31%) in Group 1REG (p = NS), and 26 (46%) in Group 2 (p = 0.004, chi-square test). Time free from all-cause death was significantly shorter in Group 1 (T1/2 = 8 years) than in Group 0 (T1/2 = 15.5 years; p = 0.00072, log-rank test). Time free from cardiovascular death was significantly shorter in Groups 1 and 2, as was time free from CAV-related death in Groups 1, 1REG, and 2. Multivariate analysis, using a Cox proportional hazards model, revealed that Group 1 inclusion criterion of CAG findings is an independent predictor of all-cause death, cardiovascular death, and CAV-related death.<br />Conclusions: Persistent mild coronary lesions, observed in consecutive CAG, predicted shorter survival of OHT recipients.<br /> (© 2013 International Society for Heart and Lung Transplantation Published by International Society for the Heart and Lung Transplantation All rights reserved.)
- Subjects :
- Adult
Aged
Cross-Sectional Studies
Female
Heart Failure diagnostic imaging
Humans
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Survival Rate
Time Factors
Coronary Angiography
Coronary Stenosis diagnostic imaging
Coronary Stenosis mortality
Heart Failure mortality
Heart Failure surgery
Heart Transplantation mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1557-3117
- Volume :
- 33
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 24388395
- Full Text :
- https://doi.org/10.1016/j.healun.2013.10.029