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Coronary revascularization after heart transplant – the search for prognostic factors

INTRODUCTION: Survival after heart transplantation (HTX) is extended due to continuous improvement of medical care, allowing enough time for coronary artery vasculopathy to develop. Data on the clinical outcome of cardiac transplantation patients after percutaneous coronary intervention (PCI) are st...

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Autores principales: Guzik, Bartlomiej, Szczepanek, Elżbieta, Niewiara, Łukasz, Nosal, Marcin, Wierzbicki, Karol, Krzanowski, Marcin, Szolc, Piotr, Kapelak, Bogusław, Żmudka, Krzysztof F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286336/
https://www.ncbi.nlm.nih.gov/pubmed/32542079
http://dx.doi.org/10.5114/aoms.2017.71847
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author Guzik, Bartlomiej
Szczepanek, Elżbieta
Niewiara, Łukasz
Nosal, Marcin
Wierzbicki, Karol
Krzanowski, Marcin
Szolc, Piotr
Kapelak, Bogusław
Żmudka, Krzysztof F.
author_facet Guzik, Bartlomiej
Szczepanek, Elżbieta
Niewiara, Łukasz
Nosal, Marcin
Wierzbicki, Karol
Krzanowski, Marcin
Szolc, Piotr
Kapelak, Bogusław
Żmudka, Krzysztof F.
author_sort Guzik, Bartlomiej
collection PubMed
description INTRODUCTION: Survival after heart transplantation (HTX) is extended due to continuous improvement of medical care, allowing enough time for coronary artery vasculopathy to develop. Data on the clinical outcome of cardiac transplantation patients after percutaneous coronary intervention (PCI) are still not extensively explored. The aim of our study was to assess whether heart transplantation itself compromises the outcome in patients undergoing percutaneous coronary intervention and to assess survival rates as well as major cardiovascular complications in heart transplant recipients who had undergone PCI. MATERIAL AND METHODS: Thirty-three heart transplant recipients who had undergone PCI in the years 2005 to 2015 in a single center were matched by age, sex and main risk factors of arteriosclerosis with 33 controls without heart transplant history. Mean age of patients was 54.6 ±11.4 years in the HTX group and 58.8 ±10.8 years in controls. Median time from heart transplant to PCI was 13 years (4.4–22 years). Case and control groups did not differ in terms of standard risk factors of coronary artery disease, apart from chronic kidney disease, which was present in 70% of patients after heart transplantation, and dyslipidemia, which was present in 91% of control subjects. RESULTS: Patients after HTX had worse survival compared to controls (p = 0.04). When adjusted for comorbidities in the Cox regression model, there was no significant difference in survival between cardiac transplant recipients and the control group (HR = 1.06; 95% CI: 0.10–11.24). Chronic renal disease was a significant predictor of all-cause mortality (HR = 29.9; 95% CI: 2.3–393). Considering other endpoints, HTX patients had considerably higher incidence of severe bleeding compared to the control group (27% vs. 3%, p < 0.05). CONCLUSIONS: There was no significant difference in myocardial infarction rate, revascularization or hospitalization rates.
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spelling pubmed-72863362020-06-14 Coronary revascularization after heart transplant – the search for prognostic factors Guzik, Bartlomiej Szczepanek, Elżbieta Niewiara, Łukasz Nosal, Marcin Wierzbicki, Karol Krzanowski, Marcin Szolc, Piotr Kapelak, Bogusław Żmudka, Krzysztof F. Arch Med Sci Clinical Research INTRODUCTION: Survival after heart transplantation (HTX) is extended due to continuous improvement of medical care, allowing enough time for coronary artery vasculopathy to develop. Data on the clinical outcome of cardiac transplantation patients after percutaneous coronary intervention (PCI) are still not extensively explored. The aim of our study was to assess whether heart transplantation itself compromises the outcome in patients undergoing percutaneous coronary intervention and to assess survival rates as well as major cardiovascular complications in heart transplant recipients who had undergone PCI. MATERIAL AND METHODS: Thirty-three heart transplant recipients who had undergone PCI in the years 2005 to 2015 in a single center were matched by age, sex and main risk factors of arteriosclerosis with 33 controls without heart transplant history. Mean age of patients was 54.6 ±11.4 years in the HTX group and 58.8 ±10.8 years in controls. Median time from heart transplant to PCI was 13 years (4.4–22 years). Case and control groups did not differ in terms of standard risk factors of coronary artery disease, apart from chronic kidney disease, which was present in 70% of patients after heart transplantation, and dyslipidemia, which was present in 91% of control subjects. RESULTS: Patients after HTX had worse survival compared to controls (p = 0.04). When adjusted for comorbidities in the Cox regression model, there was no significant difference in survival between cardiac transplant recipients and the control group (HR = 1.06; 95% CI: 0.10–11.24). Chronic renal disease was a significant predictor of all-cause mortality (HR = 29.9; 95% CI: 2.3–393). Considering other endpoints, HTX patients had considerably higher incidence of severe bleeding compared to the control group (27% vs. 3%, p < 0.05). CONCLUSIONS: There was no significant difference in myocardial infarction rate, revascularization or hospitalization rates. Termedia Publishing House 2020-04-18 /pmc/articles/PMC7286336/ /pubmed/32542079 http://dx.doi.org/10.5114/aoms.2017.71847 Text en Copyright © 2020 Termedia & Banach http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0). License (http://creativecommons.org/licenses/by-nc-sa/4.0/)
spellingShingle Clinical Research
Guzik, Bartlomiej
Szczepanek, Elżbieta
Niewiara, Łukasz
Nosal, Marcin
Wierzbicki, Karol
Krzanowski, Marcin
Szolc, Piotr
Kapelak, Bogusław
Żmudka, Krzysztof F.
Coronary revascularization after heart transplant – the search for prognostic factors
title Coronary revascularization after heart transplant – the search for prognostic factors
title_full Coronary revascularization after heart transplant – the search for prognostic factors
title_fullStr Coronary revascularization after heart transplant – the search for prognostic factors
title_full_unstemmed Coronary revascularization after heart transplant – the search for prognostic factors
title_short Coronary revascularization after heart transplant – the search for prognostic factors
title_sort coronary revascularization after heart transplant – the search for prognostic factors
topic Clinical Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7286336/
https://www.ncbi.nlm.nih.gov/pubmed/32542079
http://dx.doi.org/10.5114/aoms.2017.71847
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