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Graft coronary artery disease is strongly related to the aetiology of heart failure and cellular rejections.

Artikel i vetenskaplig tidskrift
Författare B Lindelöw
Claes-Håkan Bergh
C Lamm
Bert Andersson
Finn Waagstein
Publicerad i European heart journal
Volym 20
Nummer/häfte 18
Sidor 1326-34
ISSN 0195-668X
Publiceringsår 1999
Publicerad vid Wallenberglaboratoriet
Hjärt-kärlinstitutionen
Sidor 1326-34
Språk en
Länkar dx.doi.org/10.1053/euhj.1999.1524
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord Adolescent, Adult, Cardiomyopathy, Dilated, complications, surgery, Child, Coronary Disease, epidemiology, etiology, Disease-Free Survival, Female, Graft Rejection, epidemiology, Heart Failure, etiology, surgery, Heart Transplantation, Humans, Incidence, Longitudinal Studies, Male, Middle Aged, Myocardial Ischemia, complications, surgery, Regression Analysis, Risk Factors, Sweden, epidemiology
Ämneskategorier Kardiologi

Sammanfattning

To identify risk factors for the development of coronary artery disease after heart transplantation.In consecutive heart transplanted patients, who underwent coronary angiography at the first year follow-up, the aetiology of heart failure in 113 was ischaemic heart disease or dilated cardiomyopathy. Development of clinically significant graft coronary artery disease was analysed vs recipient and donor pre- and post-transplantation variables. At 1, 5 and 9 years follow-up, coronary artery disease had developed in 4%, 16%, and 20% of the included patients, respectively. Among patients with ischaemic heart disease as the aetiology of heart failure, 38% developed graft coronary artery disease, while the corresponding figure for patients with dilated cardiomyopathy was 9% (P<0.001) during 9 years of follow-up. In multivariate regression analysis, the aetiology of ischaemic heart disease and the number of cellular rejections were independent predictors of developing graft coronary artery disease, with risk ratios of 5.8, (95% confidence interval of 2.2-14.8 (P=0.0003)) and 3.3, (95% confidence interval of 1.7-6.5 (P=0.0004)), respectively. Classical risk factors for coronary artery disease did not influence the development of graft coronary artery disease.Ischaemic heart disease as the aetiology of heart failure and the number of cellular rejections were powerful independent predictors of development of graft coronary artery disease following heart transplantation. The low incidence of graft coronary artery disease among patients with dilated cardiomyopathy implies that coronary angiography after heart transplantation can be made on a more selective basis.

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