Long-Term Prognostic Value of Coronary CTA in Orthotopic Heart Transplant Recipients
OBJECTIVE. This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients. MATERIALS AND METHODS. The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction ≥ 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared. RESULTS. Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 ± 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (p < .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7-21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95-13; p =. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS ≥ 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46-8.23). CONCLUSION. In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2021 |
|---|---|
| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:216 |
|---|---|
| Enthalten in: |
AJR. American journal of roentgenology - 216(2021), 5 vom: 06. Mai, Seite 1216-1221 |
| Sprache: |
Englisch |
|---|
| Beteiligte Personen: |
García-Baizán, Alejandra [VerfasserIn] |
|---|
| Links: |
|---|
| Themen: |
Allograft vasculopathy |
|---|
| Anmerkungen: |
Date Completed 10.05.2021 Date Revised 10.05.2021 published: Print-Electronic Citation Status MEDLINE |
|---|
| doi: |
10.2214/AJR.20.23535 |
|---|
| funding: |
|
|---|---|
| Förderinstitution / Projekttitel: |
|
| PPN (Katalog-ID): |
NLM321828453 |
|---|
| LEADER | 01000naa a22002652 4500 | ||
|---|---|---|---|
| 001 | NLM321828453 | ||
| 003 | DE-627 | ||
| 005 | 20231225180725.0 | ||
| 007 | cr uuu---uuuuu | ||
| 008 | 231225s2021 xx |||||o 00| ||eng c | ||
| 024 | 7 | |a 10.2214/AJR.20.23535 |2 doi | |
| 028 | 5 | 2 | |a pubmed24n1072.xml |
| 035 | |a (DE-627)NLM321828453 | ||
| 035 | |a (NLM)33624522 | ||
| 040 | |a DE-627 |b ger |c DE-627 |e rakwb | ||
| 041 | |a eng | ||
| 100 | 1 | |a García-Baizán, Alejandra |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Long-Term Prognostic Value of Coronary CTA in Orthotopic Heart Transplant Recipients |
| 264 | 1 | |c 2021 | |
| 336 | |a Text |b txt |2 rdacontent | ||
| 337 | |a ƒaComputermedien |b c |2 rdamedia | ||
| 338 | |a ƒa Online-Ressource |b cr |2 rdacarrier | ||
| 500 | |a Date Completed 10.05.2021 | ||
| 500 | |a Date Revised 10.05.2021 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a OBJECTIVE. This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients. MATERIALS AND METHODS. The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction ≥ 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared. RESULTS. Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 ± 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (p < .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7-21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95-13; p =. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS ≥ 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46-8.23). CONCLUSION. In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a CT | |
| 650 | 4 | |a allograft vasculopathy | |
| 650 | 4 | |a heart | |
| 650 | 4 | |a prognosis | |
| 650 | 4 | |a transplant | |
| 700 | 1 | |a Caballeros, Meylin |e verfasserin |4 aut | |
| 700 | 1 | |a Ezponda, Ana |e verfasserin |4 aut | |
| 700 | 1 | |a Manrique, Rebeca |e verfasserin |4 aut | |
| 700 | 1 | |a Gavira, Juan J |e verfasserin |4 aut | |
| 700 | 1 | |a Rábago, Gregorio |e verfasserin |4 aut | |
| 700 | 1 | |a Bastarrika, Gorka |e verfasserin |4 aut | |
| 773 | 0 | 8 | |i Enthalten in |t AJR. American journal of roentgenology |d 1981 |g 216(2021), 5 vom: 06. Mai, Seite 1216-1221 |w (DE-627)NLM000037109 |x 1546-3141 |7 nnns |
| 773 | 1 | 8 | |g volume:216 |g year:2021 |g number:5 |g day:06 |g month:05 |g pages:1216-1221 |
| 856 | 4 | 0 | |u http://dx.doi.org/10.2214/AJR.20.23535 |3 Volltext |
| 912 | |a GBV_USEFLAG_A | ||
| 912 | |a GBV_NLM | ||
| 951 | |a AR | ||
| 952 | |d 216 |j 2021 |e 5 |b 06 |c 05 |h 1216-1221 | ||