EARLY DEVELOPMENT OF ACCELERATED GRAFT CORONARY-ARTERY DISEASE - RISK-FACTORS AND COURSE

Citation
Sz. Gag et al., EARLY DEVELOPMENT OF ACCELERATED GRAFT CORONARY-ARTERY DISEASE - RISK-FACTORS AND COURSE, Journal of the American College of Cardiology, 28(3), 1996, pp. 673-679
Citations number
20
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
0735-1097
Volume
28
Issue
3
Year of publication
1996
Pages
673 - 679
Database
ISI
SICI code
0735-1097(1996)28:3<673:EDOAGC>2.0.ZU;2-O
Abstract
Objectives. This study assessed the time of first appearance of angiog raphic graft coronary artery disease in relation to clinical and labor atory variables and clinical events in heart transplant recipients. Ba ckground. Graft coronary artery disease is the main factor limiting lo ng-term survival after heart transplantation, and it is important to u nderstand its natural history. Methods. One hundred thirty-nine consec utive patients who developed angiographic coronary artery disease afte r heart transplantation were classified according to early (less than or equal to 2 years) versus late (>2 years) posttransplantation initia l detection of coronary artery disease, These subgroups were analyzed for differences in clinical and laboratory demographics, incidence of progression to ischemic events and incidence of antecedent cytomegalov irus infection. Results. The early-onset group (64 patients) had more rapid progression to ischemic events than the late-onset group (75 pat ients), with 59% of the late group and only 35% of the early group fre e from ischemic events by 5 years after initial detection (p = 0.02), but there were no significantly correlated clinical or laboratory pred ictors of ischemic events, The early group had a significantly higher incidence of antecedent cytomegalovirus infection. Conclusions. We con clude that 1) accelerated graft coronary artery disease develops at va riable times after heart transplantation; 2) the early appearance of g raft coronary artery disease may be a marker of intrinsically more agg ressive disease; 3) cytomegalovirus infection is associated with earli er onset of graft coronary artery disease, Patients with early develop ment of graft coronary artery disease should potentially be given prio rity for interventional strategies as they are developed.