Back to Search
Start Over
Perioperative Risk Factors of Cardiac Allograft Vasculopathy in the Long-Term Follow-up.
- Source :
-
Transplantation proceedings [Transplant Proc] 2016 Jun; Vol. 48 (5), pp. 1736-41. - Publication Year :
- 2016
-
Abstract
- Background: Cardiac allograft vasculopathy (CAV) still remains to be one of the most important limiting factors for heart transplant recipients' long-term survival. The aim of our study was to identify the perioperative risk factors impacting the occurrence of CAV during the long-term follow-up.<br />Methods: We retrospectively analysed the data from 198 consecutive adult patients, who underwent heart transplantation between 2007 and 2012, in whom at least one routine coronarography (CAG) was performed. CAV onset was defined as any lesion seen at least at one routine CAG.<br />Results: The average follow-up was 63.6 ± 14.7 months. The frequency of CAV in the analysed population was 36 (18.1%). Multivariate stepwise logistic regression analysis confirmed that NT-proBNP plasma concentration directly before heart transplant [logNT-proBNP OR = 16.455 (4.587-31.036), P < .0001], fibrinogen plasma concentration a month after heart transplant [OR = 1.022 (1.009-1.035), P < .001] and occurrence of diabetes [OR = 12.355 (1.417-35.750), P < .001], were independent predictors of CAV. Area under the ROC curves (AUC) indicated a well discriminatory power of plasma fibrinogen [AUC 0.9278, P < .001] and plasma NTproBNP concentration [AUC 0.9514, P < .001] in CAV prediction. The optimal cut-off value of fibrinogen was 509 mg/dL, and of NT-proBNP was 10080 pg/mL.<br />Conclusions: Our data show that NT-proBNP and fibrinogen plasma concentrations as well as occurence of diabetes, both preexisting and new onset after heart transplant can be used to identify patients at risk of developing CAV.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Allografts
Diabetic Angiopathies complications
Female
Follow-Up Studies
Graft Rejection blood
Heart Diseases blood
Humans
Hypercholesterolemia complications
Hypertension complications
Male
Middle Aged
Natriuretic Peptide, Brain metabolism
Peptide Fragments metabolism
Retrospective Studies
Risk Factors
Time Factors
Transplantation, Homologous
Treatment Outcome
Graft Rejection etiology
Heart Diseases surgery
Heart Transplantation
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2623
- Volume :
- 48
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Transplantation proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 27496482
- Full Text :
- https://doi.org/10.1016/j.transproceed.2015.10.087