Ischemic cardiomyopathy is associated with coronary plaque progression and higher event rate in patients after cardiac transplantation

11Citations
Citations of this article
38Readers
Mendeley users who have this article in their library.

Abstract

Background: Cardiac allograft vasculopathy is the leading cause of graft failure and death in heart transplant (HTx) recipients; however, the association between the etiology of heart failure (ischemic cardiomyopathy [ICM] or non-ICM) that led to HTx and progression of cardiac allograft vasculopathy, and adverse events after HTx has not been explored. Methods and Results: We retrospectively included 165 HTx patients, who were followed-up with at least 2 virtual histology- intravascular ultrasound examinations after HTx, and grouped them as ICM (n=46) or non-ICM (n=119). Coronary artery plaque volume was analyzed using virtual histology-intravascular ultrasound, and cardiovascular event data-a composite of myocardial infarction, hospitalization for heart failure and arrhythmia, revascularization, retransplantation, and death including cardiovascular death-were collected from the medical records of all study subjects. ICM patients had significantly higher plaque volume at both first (P=0.040) and follow-up (P=0.015) intravascular ultrasound examinations. After multivariate adjustment for traditional coronary risk factors, ICM was significantly associated with plaque progression (odds ratio 3.10; CI 1.17 to 9.36; P=0.023). Tenyear cardiovascular event-free survival was 50% in ICM patients compared with 84% in non-ICM patients (log-rank test P=0.003). In multivariate Cox proportional hazard analysis, ICM was significantly associated with a higher event rate after HTx (hazard ratio 2.02; 95% CI 1.01 to 4.00; P=0.048). Conclusion: Our study demonstrates that ischemic etiology of cardiomyopathy prior to HTx may be independently associated with plaque progression and higher event rate after HTx.

Cite

CITATION STYLE

APA

Guddeti, R. R., Matsuo, Y., Matsuzawa, Y., Aoki, T., Lennon, R. J., Lerman, L. O., … Lerman, A. (2014). Ischemic cardiomyopathy is associated with coronary plaque progression and higher event rate in patients after cardiac transplantation. Journal of the American Heart Association, 3(4). https://doi.org/10.1161/JAHA.114.001091

Register to see more suggestions

Mendeley helps you to discover research relevant for your work.

Already have an account?

Save time finding and organizing research with Mendeley

Sign up for free