Loading…
The role of estrogen, immune function and aging in heart transplant outcomes
Aging and loss of estrogen suppress immune function, potentially improving survival after orthotopic heart transplant (OHT). The effect of female aging on OHT outcomes is unknown. Between 1995 and 2015, 41,299 adult OHT recipients (24.3% women) were studied using a retrospective multi-institutional...
Saved in:
| Published in: | The American journal of surgery 2019-10, Vol.218 (4), p.737-743 |
|---|---|
| Main Authors: | , , , , , , , |
| Format: | Article |
| Language: | English |
| Subjects: | |
| Citations: | Items that this one cites Items that cite this one |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| cited_by | cdi_FETCH-LOGICAL-c393t-c25055841d465bb079cba48b62fe23b79fb555d43942409796016e00b1a9f1473 |
|---|---|
| cites | cdi_FETCH-LOGICAL-c393t-c25055841d465bb079cba48b62fe23b79fb555d43942409796016e00b1a9f1473 |
| container_end_page | 743 |
| container_issue | 4 |
| container_start_page | 737 |
| container_title | The American journal of surgery |
| container_volume | 218 |
| creator | Morgan, Ashley E. Dewey, Elizabeth Mudd, James O. Gelow, Jill M. Davis, Jonathan Song, Howard K. Tibayan, Frederick A. Bhamidipati, Castigliano M. |
| description | Aging and loss of estrogen suppress immune function, potentially improving survival after orthotopic heart transplant (OHT). The effect of female aging on OHT outcomes is unknown.
Between 1995 and 2015, 41,299 adult OHT recipients (24.3% women) were studied using a retrospective multi-institutional cohort. Patients were stratified by age and gender into premenopausal (18–39 years), perimenopausal (40–49 years), and postmenopausal (≥50 years) groups. Kaplan-Meier survival analyses and risk-adjusted models examined gender differences across groups at one, five, and ten years.
Kaplan-Meier survival was equivalent for postmenopausal women and men, and lower for premenopausal women than men at all time points (p ≤ 0.05). Postmenopausal women had higher risk-adjusted five-year survival than premenopausal women (AOR 1.61, 95% CI 1.15–2.25, p = 0.006).
Premenopausal women have lower unadjusted survival than men after OHT. Post-menopausal women have significantly better five-year survival than pre-menopausal women. Menopause may contribute to improved survival after OHT.
•We compared survival between age-matched men and women after heart transplant.•Post-menopausal women and age-matched men had equivalent unadjusted survival.•Risk-adjusted survival was equivalent between men and women of all age groups.•Postmenopausal women had better risk-adjusted survival than premenopausal women.•Menopause, with associated loss of estrogen, may improve survival after transplant. |
| doi_str_mv | 10.1016/j.amjsurg.2019.07.007 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2266337158</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002961019301679</els_id><sourcerecordid>2266337158</sourcerecordid><originalsourceid>FETCH-LOGICAL-c393t-c25055841d465bb079cba48b62fe23b79fb555d43942409796016e00b1a9f1473</originalsourceid><addsrcrecordid>eNqFkE2LFDEQhoMo7uzqT1ACXjzYbeWr0zmJLLoKA17Wc0inq2fTTCdj0i34780yowcvnoqCp6reegh5xaBlwLr3c-uWuWz50HJgpgXdAugnZMd6bRrW9-Ip2QEAb0zH4IpclzLXljEpnpMrwYQSIPiO7O8fkOZ0RJomimXN6YDxHQ3LskWk0xb9GlKkLo7UHUI80BDpA7q80jW7WE5HF1eattWnBcsL8mxyx4IvL_WGfP_86f72S7P_dvf19uO-8cKItfFcgVK9ZKPs1DCANn5wsh86PiEXgzbToJQapTCSSzDadPVhBBiYMxOTWtyQt-e9p5x-bDW1XULxeKxhMG3Fct51Qmim-oq--Qed05ZjTVcp00MvBeeVUmfK51RKxsmeclhc_mUZ2EfddrYX3fZRtwVtq-469_qyfRsWHP9O_fFbgQ9nAKuOnwGzLT5g9DiGjH61Ywr_OfEbAKKRjA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2298084322</pqid></control><display><type>article</type><title>The role of estrogen, immune function and aging in heart transplant outcomes</title><source>ScienceDirect Journals</source><creator>Morgan, Ashley E. ; Dewey, Elizabeth ; Mudd, James O. ; Gelow, Jill M. ; Davis, Jonathan ; Song, Howard K. ; Tibayan, Frederick A. ; Bhamidipati, Castigliano M.</creator><creatorcontrib>Morgan, Ashley E. ; Dewey, Elizabeth ; Mudd, James O. ; Gelow, Jill M. ; Davis, Jonathan ; Song, Howard K. ; Tibayan, Frederick A. ; Bhamidipati, Castigliano M.</creatorcontrib><description>Aging and loss of estrogen suppress immune function, potentially improving survival after orthotopic heart transplant (OHT). The effect of female aging on OHT outcomes is unknown.
Between 1995 and 2015, 41,299 adult OHT recipients (24.3% women) were studied using a retrospective multi-institutional cohort. Patients were stratified by age and gender into premenopausal (18–39 years), perimenopausal (40–49 years), and postmenopausal (≥50 years) groups. Kaplan-Meier survival analyses and risk-adjusted models examined gender differences across groups at one, five, and ten years.
Kaplan-Meier survival was equivalent for postmenopausal women and men, and lower for premenopausal women than men at all time points (p ≤ 0.05). Postmenopausal women had higher risk-adjusted five-year survival than premenopausal women (AOR 1.61, 95% CI 1.15–2.25, p = 0.006).
Premenopausal women have lower unadjusted survival than men after OHT. Post-menopausal women have significantly better five-year survival than pre-menopausal women. Menopause may contribute to improved survival after OHT.
•We compared survival between age-matched men and women after heart transplant.•Post-menopausal women and age-matched men had equivalent unadjusted survival.•Risk-adjusted survival was equivalent between men and women of all age groups.•Postmenopausal women had better risk-adjusted survival than premenopausal women.•Menopause, with associated loss of estrogen, may improve survival after transplant.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/j.amjsurg.2019.07.007</identifier><identifier>PMID: 31353032</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Age ; Age Factors ; Aging ; Antigens ; Autoimmune diseases ; Cardiac Output ; Diabetes ; Estrogens ; Female ; Gender ; Gender aspects ; Heart failure ; Heart Failure - immunology ; Heart Failure - mortality ; Heart Failure - surgery ; Heart transplantation ; Heart Transplantation - mortality ; Hemodialysis ; Humans ; Hypotheses ; Hypothesis testing ; Immune response ; Kaplan-Meier Estimate ; Male ; Men ; Menopause ; Middle Aged ; Patients ; Post-menopause ; Retrospective Studies ; Sex differences ; Sex Factors ; Survival ; Survival Rate ; Transplants & implants ; Ventilators ; Women ; Womens health ; Young Adult</subject><ispartof>The American journal of surgery, 2019-10, Vol.218 (4), p.737-743</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><rights>2019. Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-c25055841d465bb079cba48b62fe23b79fb555d43942409796016e00b1a9f1473</citedby><cites>FETCH-LOGICAL-c393t-c25055841d465bb079cba48b62fe23b79fb555d43942409796016e00b1a9f1473</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31353032$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morgan, Ashley E.</creatorcontrib><creatorcontrib>Dewey, Elizabeth</creatorcontrib><creatorcontrib>Mudd, James O.</creatorcontrib><creatorcontrib>Gelow, Jill M.</creatorcontrib><creatorcontrib>Davis, Jonathan</creatorcontrib><creatorcontrib>Song, Howard K.</creatorcontrib><creatorcontrib>Tibayan, Frederick A.</creatorcontrib><creatorcontrib>Bhamidipati, Castigliano M.</creatorcontrib><title>The role of estrogen, immune function and aging in heart transplant outcomes</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Aging and loss of estrogen suppress immune function, potentially improving survival after orthotopic heart transplant (OHT). The effect of female aging on OHT outcomes is unknown.
Between 1995 and 2015, 41,299 adult OHT recipients (24.3% women) were studied using a retrospective multi-institutional cohort. Patients were stratified by age and gender into premenopausal (18–39 years), perimenopausal (40–49 years), and postmenopausal (≥50 years) groups. Kaplan-Meier survival analyses and risk-adjusted models examined gender differences across groups at one, five, and ten years.
Kaplan-Meier survival was equivalent for postmenopausal women and men, and lower for premenopausal women than men at all time points (p ≤ 0.05). Postmenopausal women had higher risk-adjusted five-year survival than premenopausal women (AOR 1.61, 95% CI 1.15–2.25, p = 0.006).
Premenopausal women have lower unadjusted survival than men after OHT. Post-menopausal women have significantly better five-year survival than pre-menopausal women. Menopause may contribute to improved survival after OHT.
•We compared survival between age-matched men and women after heart transplant.•Post-menopausal women and age-matched men had equivalent unadjusted survival.•Risk-adjusted survival was equivalent between men and women of all age groups.•Postmenopausal women had better risk-adjusted survival than premenopausal women.•Menopause, with associated loss of estrogen, may improve survival after transplant.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Age</subject><subject>Age Factors</subject><subject>Aging</subject><subject>Antigens</subject><subject>Autoimmune diseases</subject><subject>Cardiac Output</subject><subject>Diabetes</subject><subject>Estrogens</subject><subject>Female</subject><subject>Gender</subject><subject>Gender aspects</subject><subject>Heart failure</subject><subject>Heart Failure - immunology</subject><subject>Heart Failure - mortality</subject><subject>Heart Failure - surgery</subject><subject>Heart transplantation</subject><subject>Heart Transplantation - mortality</subject><subject>Hemodialysis</subject><subject>Humans</subject><subject>Hypotheses</subject><subject>Hypothesis testing</subject><subject>Immune response</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Men</subject><subject>Menopause</subject><subject>Middle Aged</subject><subject>Patients</subject><subject>Post-menopause</subject><subject>Retrospective Studies</subject><subject>Sex differences</subject><subject>Sex Factors</subject><subject>Survival</subject><subject>Survival Rate</subject><subject>Transplants & implants</subject><subject>Ventilators</subject><subject>Women</subject><subject>Womens health</subject><subject>Young Adult</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqFkE2LFDEQhoMo7uzqT1ACXjzYbeWr0zmJLLoKA17Wc0inq2fTTCdj0i34780yowcvnoqCp6reegh5xaBlwLr3c-uWuWz50HJgpgXdAugnZMd6bRrW9-Ip2QEAb0zH4IpclzLXljEpnpMrwYQSIPiO7O8fkOZ0RJomimXN6YDxHQ3LskWk0xb9GlKkLo7UHUI80BDpA7q80jW7WE5HF1eattWnBcsL8mxyx4IvL_WGfP_86f72S7P_dvf19uO-8cKItfFcgVK9ZKPs1DCANn5wsh86PiEXgzbToJQapTCSSzDadPVhBBiYMxOTWtyQt-e9p5x-bDW1XULxeKxhMG3Fct51Qmim-oq--Qed05ZjTVcp00MvBeeVUmfK51RKxsmeclhc_mUZ2EfddrYX3fZRtwVtq-469_qyfRsWHP9O_fFbgQ9nAKuOnwGzLT5g9DiGjH61Ywr_OfEbAKKRjA</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Morgan, Ashley E.</creator><creator>Dewey, Elizabeth</creator><creator>Mudd, James O.</creator><creator>Gelow, Jill M.</creator><creator>Davis, Jonathan</creator><creator>Song, Howard K.</creator><creator>Tibayan, Frederick A.</creator><creator>Bhamidipati, Castigliano M.</creator><general>Elsevier Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>201910</creationdate><title>The role of estrogen, immune function and aging in heart transplant outcomes</title><author>Morgan, Ashley E. ; Dewey, Elizabeth ; Mudd, James O. ; Gelow, Jill M. ; Davis, Jonathan ; Song, Howard K. ; Tibayan, Frederick A. ; Bhamidipati, Castigliano M.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c393t-c25055841d465bb079cba48b62fe23b79fb555d43942409796016e00b1a9f1473</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Age</topic><topic>Age Factors</topic><topic>Aging</topic><topic>Antigens</topic><topic>Autoimmune diseases</topic><topic>Cardiac Output</topic><topic>Diabetes</topic><topic>Estrogens</topic><topic>Female</topic><topic>Gender</topic><topic>Gender aspects</topic><topic>Heart failure</topic><topic>Heart Failure - immunology</topic><topic>Heart Failure - mortality</topic><topic>Heart Failure - surgery</topic><topic>Heart transplantation</topic><topic>Heart Transplantation - mortality</topic><topic>Hemodialysis</topic><topic>Humans</topic><topic>Hypotheses</topic><topic>Hypothesis testing</topic><topic>Immune response</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Men</topic><topic>Menopause</topic><topic>Middle Aged</topic><topic>Patients</topic><topic>Post-menopause</topic><topic>Retrospective Studies</topic><topic>Sex differences</topic><topic>Sex Factors</topic><topic>Survival</topic><topic>Survival Rate</topic><topic>Transplants & implants</topic><topic>Ventilators</topic><topic>Women</topic><topic>Womens health</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Morgan, Ashley E.</creatorcontrib><creatorcontrib>Dewey, Elizabeth</creatorcontrib><creatorcontrib>Mudd, James O.</creatorcontrib><creatorcontrib>Gelow, Jill M.</creatorcontrib><creatorcontrib>Davis, Jonathan</creatorcontrib><creatorcontrib>Song, Howard K.</creatorcontrib><creatorcontrib>Tibayan, Frederick A.</creatorcontrib><creatorcontrib>Bhamidipati, Castigliano M.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>ProQuest_Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest research library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morgan, Ashley E.</au><au>Dewey, Elizabeth</au><au>Mudd, James O.</au><au>Gelow, Jill M.</au><au>Davis, Jonathan</au><au>Song, Howard K.</au><au>Tibayan, Frederick A.</au><au>Bhamidipati, Castigliano M.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The role of estrogen, immune function and aging in heart transplant outcomes</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2019-10</date><risdate>2019</risdate><volume>218</volume><issue>4</issue><spage>737</spage><epage>743</epage><pages>737-743</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><abstract>Aging and loss of estrogen suppress immune function, potentially improving survival after orthotopic heart transplant (OHT). The effect of female aging on OHT outcomes is unknown.
Between 1995 and 2015, 41,299 adult OHT recipients (24.3% women) were studied using a retrospective multi-institutional cohort. Patients were stratified by age and gender into premenopausal (18–39 years), perimenopausal (40–49 years), and postmenopausal (≥50 years) groups. Kaplan-Meier survival analyses and risk-adjusted models examined gender differences across groups at one, five, and ten years.
Kaplan-Meier survival was equivalent for postmenopausal women and men, and lower for premenopausal women than men at all time points (p ≤ 0.05). Postmenopausal women had higher risk-adjusted five-year survival than premenopausal women (AOR 1.61, 95% CI 1.15–2.25, p = 0.006).
Premenopausal women have lower unadjusted survival than men after OHT. Post-menopausal women have significantly better five-year survival than pre-menopausal women. Menopause may contribute to improved survival after OHT.
•We compared survival between age-matched men and women after heart transplant.•Post-menopausal women and age-matched men had equivalent unadjusted survival.•Risk-adjusted survival was equivalent between men and women of all age groups.•Postmenopausal women had better risk-adjusted survival than premenopausal women.•Menopause, with associated loss of estrogen, may improve survival after transplant.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31353032</pmid><doi>10.1016/j.amjsurg.2019.07.007</doi><tpages>7</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0002-9610 |
| ispartof | The American journal of surgery, 2019-10, Vol.218 (4), p.737-743 |
| issn | 0002-9610 1879-1883 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2266337158 |
| source | ScienceDirect Journals |
| subjects | Adolescent Adult Age Age Factors Aging Antigens Autoimmune diseases Cardiac Output Diabetes Estrogens Female Gender Gender aspects Heart failure Heart Failure - immunology Heart Failure - mortality Heart Failure - surgery Heart transplantation Heart Transplantation - mortality Hemodialysis Humans Hypotheses Hypothesis testing Immune response Kaplan-Meier Estimate Male Men Menopause Middle Aged Patients Post-menopause Retrospective Studies Sex differences Sex Factors Survival Survival Rate Transplants & implants Ventilators Women Womens health Young Adult |
| title | The role of estrogen, immune function and aging in heart transplant outcomes |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-21T05%3A21%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=The%20role%20of%20estrogen,%20immune%20function%20and%20aging%20in%20heart%20transplant%20outcomes&rft.jtitle=The%20American%20journal%20of%20surgery&rft.au=Morgan,%20Ashley%20E.&rft.date=2019-10&rft.volume=218&rft.issue=4&rft.spage=737&rft.epage=743&rft.pages=737-743&rft.issn=0002-9610&rft.eissn=1879-1883&rft_id=info:doi/10.1016/j.amjsurg.2019.07.007&rft_dat=%3Cproquest_cross%3E2266337158%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c393t-c25055841d465bb079cba48b62fe23b79fb555d43942409796016e00b1a9f1473%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2298084322&rft_id=info:pmid/31353032&rfr_iscdi=true |