Influence of Traditional Cardiovascular Risk Factors in the Recipient on the Development of Cardiac Allograft Vasculopathy After Heart Transplantation

• Published in: Transplantation proceedings Vol. 40; no. 9; pp. 3056 - 3057
• Main Authors: Lázaro, I.J.Sánchez, Bonet, L. Almenar, López, J. Moro, Lacuesta, E.Sánchez, Martínez-Dolz, L, Ramón-Llín, J. Agüero, Lalaguna, L. Andrés, Pérez, O. Cano, Martínez, V. Ortiz, Fuentes, F. Buendía, Sanz, A. Salvador
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Amsterdam Elsevier Inc 01-11-2008; Elsevier
• Subjects: Analysis of Variance; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Body Mass Index; Cardiology. Vascular system; Cardiovascular Diseases - epidemiology; Dyslipidemias - complications; Female; Follow-Up Studies; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Heart Diseases - classification; Heart Diseases - surgery; Heart Transplantation - adverse effects; Heart Transplantation - mortality; Heart Transplantation - pathology; Humans; Male; Medical sciences; Middle Aged; Retrospective Studies; Risk Factors; Smoking - epidemiology; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Time Factors; Tissue, organ and graft immunology; Transplantation, Homologous - pathology; Vascular Diseases - epidemiology; Heart; Human; Cardiovascular disease; Recipient; Transplantation; Homotransplantation; Epidemiology; Vascular disease; Medicine; Graft vascular disease; Treatment; Surgery; Atherosclerosis; Risk factor; Cardiovascular risk; Development; Graft; Circulatory system; Influence factor
• DOI: 10.1016/j.transproceed.2008.08.115
• EISSN: 1873-2623
• ISSN: 0041-1345

Abstract Background Cardiac allograft vasculopathy (CAV) is the leading cause of death heart transplant (HT) recipients after the first year. We assessed the influence of cardiovascular risk factors (CVRFs) in HT recipients on the development of CAV after 1 year of follow-up. Materials and Methods From 2001 to 2005, we studied 72 patients who received a HT and survived for at least 1 years. All patients underwent coronary arteriography and intravascular ultrasonography at 1 year after HT. Cardiac allograft vasculopathy was defined as intimal proliferation of 0.5 mm or more. The analyzed CVRFs were age, sex, body mass index, diabetes mellitus, hypertension, dyslipidemia, and smoking. We also considered the heart disease that was the reason for HT. The statistical tests used in the univariate analysis were the t and χ2 tests. Logistic regression was performed with the variables obtained at univariate analysis. Results Mean (SD) recipient age at HT was 51 (9) years. Eighty patients (90.5%) were men. Dyslipidemia was significantly associated with a greater incidence of CAV at 1 year (68.3% vs 41.9%; P = .03). Ischemia, as opposed to all other causes, was also significantly associated with CAV (69.4% vs 44.4%; P = .03). Older age, hypertension, smoking history, and high body mass index were associated with a higher incidence of CAV, albeit without statistical significance. At multivariate analysis, dyslipidemia was the most significant CVRF ( P = .045) for the development of CAV. Conclusions Recipient dyslipidemia is a risk factor for the development of CAV in HT. The remaining traditional CVRFs are more weakly associated with CAV. After HT close monitoring of recipients with pretransplantation CVRFs is essential for early detection of CAV.