RELATION OF DONOR AGE AND PREEXISTING CORONARY-ARTERY DISEASE ON ANGIOGRAPHY AND INTRACORONARY ULTRASOUND TO LATER DEVELOPMENT OF ACCELERATED ALLOGRAFT CORONARY-ARTERY DISEASE

Citation
Sz. Gao et al., RELATION OF DONOR AGE AND PREEXISTING CORONARY-ARTERY DISEASE ON ANGIOGRAPHY AND INTRACORONARY ULTRASOUND TO LATER DEVELOPMENT OF ACCELERATED ALLOGRAFT CORONARY-ARTERY DISEASE, Journal of the American College of Cardiology, 29(3), 1997, pp. 623-629
Citations number
22
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Cardiac & Cardiovascular System
ISSN journal
0735-1097
Volume
29
Issue
3
Year of publication
1997
Pages
623 - 629
Database
ISI
SICI code
0735-1097(1997)29:3<623:RODAAP>2.0.ZU;2-4
Abstract
Objectives. This study assessed the influence of donor age and preexis ting donor coronary artery disease on the later development of allogra ft coronary artery disease, ischemic events and overall survival. Back ground. The increasing demand for heart donors has led to a tendency t o liberalize age criteria for donor acceptability. Methods. A total of 233 consecutive heart transplant recipients who had baseline, early p ostoperative and follow-up coronary angiograms, as well as a subset of 47 patients with baseline intracoronary ultrasound imaging recordings , were analyzed (mean 3.8 years of follow-up). Patients were subclassi fied according to the presence of donor coronary artery disease on the baseline angiogram and stratified at age 40 years. Results. Patients without evidence of preexisting coronary artery disease on a baseline angiogram (n = 219) were significantly less likely to develop new dise ase than the 14 patients with preexisting coronary artery disease (p = 0.002). Although older donors exhibited earlier coronary artery disea se than younger donors at 3 years of follow-np, there was no differenc e by 5 years (p = 0.25). There was no difference in survival or probab ility of developing ischemic events between the groups. Baseline ultra sound imaging revealed substantial disease in 7 of 9 older donated hea rts, and in only 7 of 38 younger donated hearts (p = 0.002). Preexisti ng coronary artery disease, nonuse of calcium channel blocking agents, older donor age, posttransplantation cytomegalovirus infection, eleva ted very low density lipoprotein levels and previous ischemic heart di sease in the recipient were significant predictors of allograft corona ry artery disease. Conclusions. Heart donors with angiographic evidenc e of preexisting coronary artery disease and older donors are more lik ely to develop new allograft coronary artery disease by 3 Sears. Howev er, there is no difference in patient survival or freedom from ischemi c events between younger and older donors at a mean follow-up of 3.8 y ears. (C) 1997 by the American College of Cardiology.