1. Inicio
  2. Publicaciones
  3. Prevalence, Characteristics, and Prognostic Relevance of Donor-Transmitted Coronary Artery Disease in Heart Transplant Recipients.

Prevalence, Characteristics, and Prognostic Relevance of Donor-Transmitted Coronary Artery Disease in Heart Transplant Recipients.

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Couto-Mallón D
  • Barge-Caballero E
  • Hernández-Pérez FJ
  • López-Azor García JC
  • Valero-Masa MJ
  • Castel-Lavilla MÁ
  • Mirabet-Pérez S
  • Garrido-Bravo IP
  • Díez-López C
  • López-Granados A
  • Manrique-Antón R
  • Fernández-Pombo CN
  • Muñiz J
  • Crespo-Leiro MG

Grupos

Abstract

BACKGROUND: The reported prevalence of donor-transmitted coronary artery disease (TCAD) in heart transplantation (HT) is variable, and its prognostic impact remains unclear. OBJECTIVES: The goal of this study was to characterize TCAD in a contemporary multicentric cohort and to study its prognostic relevance. METHODS: This was a retrospective study of consecutive patients >18 years old who underwent HT in 11 Spanish centers from 2008 to 2018. Only patients with a coronary angiography (c-angio) within the first 3 months after HT were studied. Significant TCAD (s-TCAD) was defined as any stenosis =50% in epicardial coronary arteries, and nonsignificant TCAD (ns-TCAD) as stenosis <50%. Clinical outcomes were assessed by means of Cox regression and competing risks regression. Patients were followed-up for a median period of 6.3 years after c-angio. RESULTS: From a cohort of 1,918 patients, 937 underwent c-angio. TCAD was found in 172 patients (18.3%): s-TCAD in 65 (6.9%) and ns-TCAD in 107 (11.4%). Multivariable Cox regression analysis did not show a statistically significant association between s-TCAD and all-cause mortality (adjusted HR: 1.44; 95% CI: 0.89-2.35; P = 0.141); however, it was an independent predictor of cardiovascular mortality (adjusted HR: 2.25; 95% CI: 1.20-4.19; P = 0.011) and the combined event cardiovascular death or nonfatal MACE (adjusted HR: 2.42; 95% CI: 1.52-3.85; P < 0.001). No statistically significant impact of ns-TCAD on clinical outcomes was detected. The results were similar when reassessed by means of competing risks regression. CONCLUSIONS: TCAD was not associated with reduced survival in patients alive and well enough to undergo post-HT angiography within the first 3 months; however, s-TCAD patients showed increased risk of cardiovascular death and MACE.

Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Datos de la publicación

ISSN/ISSNe:
0735-1097, 1558-3597

JACC-Journal of the American College of Cardiology  ELSEVIER SCIENCE INC

Tipo:
Article
Páginas:
753-767
PubMed:
37612006
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
9,756 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 12

Citas Recibidas en Scopus: 13

Documentos

  • No hay documentos

Métricas

Filiaciones mostrar / ocultar

Keywords

  • donor coronary artery disease; donor selection; heart transplantation; transplant survival

Campos de Estudio

Cita

Compartir