Vol 58, No 2 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28
Get Citation

Coronary artery disease in heart transplant recipients - diagnosis and treatment. Single centre experience based on results of elective coronary angiography

Michał Zakliczyński, Andrzej Lekston, Marcin Świerad, Andrzej Wnęk, Paweł Buszman, Roman Przybylski, Jacek Wojarski, Jan Przybylski, Jerzy Foremny, Marian Zembala
Kardiol Pol 2003;58(2):115-120.
Vol 58, No 2 (2003)
Other
Published online: 2005-12-12
Submitted: 2012-12-28

Abstract

Background: Despite recent progress in clinical transplantology, coronary artery disease of transplanted heart (TxCAD) remains the main cause of long-term mortality. The role of elective coronary angiography (CAG) and percutaneous coronary interventions (PCI) in these patients has not yet been well established.
Aim: To evaluate the incidence of TxCAD based on the results of elective CAG and to assess the role of potential risk factors and treatment options.
Methods: We analysed the results of 227 elective CAG procedures performed in 145 patients after orthotopic heart transplantation (OHT) between 1986 and 1998. The result of CAG was considered positive when any lesion was found in coronary arteries regardless of its hemodynamic relevance, including both atherosclerotic plaques and lesions characteristic of vasculopathy. The influence of immunological (rejection of transplanted heart) and non-immunological risk factors on the development of TxCAD was analysed separately for the first 3 years after OHT and for the subsequent period.
Results: Positive result of at least one CAG was found in 54 (37%) patients. The overall percentage of positive CAG was 41%, starting from 18% one year after OHT to 55% five years after surgery. Vasculopathic lesions were found in 14% of CAG procedures. Risk factor analysis showed an increasing impact over time of non-immunological factors, however, differences were not statistically significant. Hemodynamically significant lesions were found in 21 patients. In 16 of those PCI was performed. Control CAG was done in 12 patients after PCI revealing indications for another PCI in 8 of them. TxCAD was the cause of death in 3 patients in the PCI group.
Conclusions: Based on the results of elective CAG, frequency of TxCAD increases with time and reaches 55% by 5 years after OHT. PCI is an effective method of treating significant coronary lesions after OHT.

Abstract

Background: Despite recent progress in clinical transplantology, coronary artery disease of transplanted heart (TxCAD) remains the main cause of long-term mortality. The role of elective coronary angiography (CAG) and percutaneous coronary interventions (PCI) in these patients has not yet been well established.
Aim: To evaluate the incidence of TxCAD based on the results of elective CAG and to assess the role of potential risk factors and treatment options.
Methods: We analysed the results of 227 elective CAG procedures performed in 145 patients after orthotopic heart transplantation (OHT) between 1986 and 1998. The result of CAG was considered positive when any lesion was found in coronary arteries regardless of its hemodynamic relevance, including both atherosclerotic plaques and lesions characteristic of vasculopathy. The influence of immunological (rejection of transplanted heart) and non-immunological risk factors on the development of TxCAD was analysed separately for the first 3 years after OHT and for the subsequent period.
Results: Positive result of at least one CAG was found in 54 (37%) patients. The overall percentage of positive CAG was 41%, starting from 18% one year after OHT to 55% five years after surgery. Vasculopathic lesions were found in 14% of CAG procedures. Risk factor analysis showed an increasing impact over time of non-immunological factors, however, differences were not statistically significant. Hemodynamically significant lesions were found in 21 patients. In 16 of those PCI was performed. Control CAG was done in 12 patients after PCI revealing indications for another PCI in 8 of them. TxCAD was the cause of death in 3 patients in the PCI group.
Conclusions: Based on the results of elective CAG, frequency of TxCAD increases with time and reaches 55% by 5 years after OHT. PCI is an effective method of treating significant coronary lesions after OHT.
Get Citation

Keywords

heart transplant - coronary artery disease - coronary angiography

About this article
Title

Coronary artery disease in heart transplant recipients - diagnosis and treatment. Single centre experience based on results of elective coronary angiography

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 58, No 2 (2003)

Pages

115-120

Published online

2005-12-12

Bibliographic record

Kardiol Pol 2003;58(2):115-120.

Keywords

heart transplant - coronary artery disease - coronary angiography

Authors

Michał Zakliczyński
Andrzej Lekston
Marcin Świerad
Andrzej Wnęk
Paweł Buszman
Roman Przybylski
Jacek Wojarski
Jan Przybylski
Jerzy Foremny
Marian Zembala

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl