Incidence of Development of Obesity After Heart Transplantation According to the Calcineurin Inhibitor

Autores de IIS La Fe

• Raquel López Vilella

  Autor

• Ignacio José Sánchez Lázaro

  Autor

• 

  Luis Vicente Martínez Dolz

  Autor

• Luis Almenar Bonet

  Autor

• Elena Marqués Sulé

  Autor

• Josep Lluís Melero Ferrer

  Autor

• Manuel Portoles Sanz

  Autor

• Jose Miguel Rivera Otero

  Autor

• Diana Domingo Valero

  Autor

• José Anastasio Montero Argudo

  Autor

Grupos

• Grupo de Investigación Clínica y Traslacional en Cardiología

• Hemostasia, Trombosis, Arteriosclerosis y Biología vascular

• Regeneración y Trasplante Cardíaco

Abstract

Background. Development of obesity after heart transplantation (HT) is a common complication, largely attributed to immunosuppressive therapy. The objective of this study is to compare the incidence of development of obesity after FIT, according to the calcineurin inhibitor (CNI) used (cyclosporine [CsA] vs tacrolimus [Tac]). Methods. We studied 101 consecutive HT patients from November 2006 to December 2010. A diagnosis of overweight obesity was made by a body mass index of >25 kg/m(2), which was assessed before HT and at 1 year after HT. Patients were randomly assigned to the administration of CsA or Tac by a simple randomization method using a computer program (56% received CsA and 44% Tac). Results. Of the 101 patients, 77% were men, and ischemic heart disease was the most common indication for HT. At baseline, there were no differences in weight between groups treated with CsA or Tac. The mean weight for each group was 71.5 +/- 12 and 75 +/- 14 kg, respectively (P = .2). The weight increase was greater among CsA patients: after HT, the weight gain was 6.9 +/- 11 kg in the CsA group, whereas a minimal weight loss of 0.03 +/- 14 kg (P = .008) was experienced in the group treated with Tac. The multivariate analysis showed that only CsA treatment was an independent predictor of development of obesity 1 year after HT (odds ratio, 3.84; 95% CI, 1.04-14.21; P = .01). Conclusion. Weight gain after HT may be related to the CNI used and CsA seems to be the CNI that produces the greatest increase.