Risk factors for the development of coronary artery disease of a grafted heart as detected very early after orthotopic heart transplantation

Abstract

Summary Orthotopic heart transplantation (OHTx) represents a well established method of end‐stage heart failure treatment. Allograft coronary artery disease (CAD) still remains to be one of the most important limiting factors for OHTx recipients’ long‐term survival. Unfortunately, allograft CAD can be detected very early after OHTx. Our study was designed to identify risk factors for early allograft CAD development. Eighty‐three OHTx recipients (18 females, 65 males, mean age 50.55 ± 11.04 years) with coronary intravascular ultrasound examination performed early after OHTx (29.81 ± 12.45 days) formed the study population. The impact of a number of pre‐, peri‐ and early post‐transplant possible risk factors on early allograft CAD development was studied. By multivariate analysis, only higher donor age (P < 0.001) and higher recipient's body mass index (P = 0.003) were found to represent risk factors for the early development of allograft CAD.

Prediction model for cardiac allograft vasculopathy: Comparison of three multivariable methods

“…Donor‐transmitted coronary atherosclerosis has also been associated with the development of CAV . The recipient variables we identified—increasing recipient BMI and ischemic heart disease or re‐transplantation as the etiology of cardiomyopathy—have also been suggested as predictors of CAV …”

Prevalence of Different Gadolinium Enhancement Patterns in Patients After Heart Transplantation

“…Nowadays, chronic sequels such as interstitial myocardial fibrosis due to immunosuppressive therapy as well as elevated immune-activated vascular atherosclerosis, also called transplant coronary artery disease (TCAD), play a more advanced role in the aftercare of HTX (3).…”

The Presentation and Diagnosis of Coronary Allograft Vasculopathy in Pediatric Heart Transplant Recipients

“…Recipient risk factors include male sex, older age, early severe rejection, increased number of rejection episodes, cytomegalovirus (CMV) infection, diabetes, hypertension, hyperlipidemia, long-term steroid use and obesity. [2][3][4][5][6][7][8] The data are limited regarding the development of CAV in children post-heart transplant. According to the ISHLT registry data, 60% of pediatric recipients are free of CAV at 11 years post-heart transplant.…”

“…Previous adult and pediatric studies have shown that older donor age, male sex, and hypertension are associated with a higher risk of CAV. Recipient risk factors include male sex, older age, early severe rejection, increased number of rejection episodes, cytomegalovirus (CMV) infection, diabetes, hypertension, hyperlipidemia, long‐term steroid use and obesity 2–8 . The data are limited regarding the development of CAV in children post–heart transplant.…”