Do Cardiovascular Risk Factors Influence Cardiac Allograft Vasculopathy?

• Published in: Transplantation proceedings 2006-10, Vol.38 (8), p.2572-2574
• Main Authors: Chamorro, C.I., Almenar, L., Martı́nez-Dolz, L., Sánchez-Lacuesta, E., Martı́n-Pastor, J., Ten-Morro, F., Sánchez-Soriano, R.M., Agüero, J., Ortiz, V., Moro, J.A., Salvador, A.
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Analysis of Variance; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular Diseases - epidemiology; Coronary Angiography; Diabetes Mellitus - epidemiology; Dyslipidemias - epidemiology; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Heart Transplantation - pathology; Humans; Medical sciences; Middle Aged; Risk Factors; Smoking; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Tissue, organ and graft immunology; Transplantation, Homologous - pathology; Ultrasonography, Interventional
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2006.08.034

Cardiac allograft vasculopathy (CAV) is the leading cause of heart transplant failure after the first year. The etiological factors involved are currently a controversial matter. Intravascular ultrasound (IVUS) is considered the diagnostic procedure of choice. We assessed the relationship of cardiovascular risk factors with CAV. We analyzed prospectively 22 patients. We conducted a first study with coronary angiography and IVUS at 36 ± 3 days and a second at 598 ± 49 days. We performed an average of 5.6 clinical revisions per patient, assessing the effect of the classic cardiovascular risk factors, the cause of heart failure, and the age of the patient and donor. The statistics used were χ 2, Fisher exact test, and Student t test. CAV was found in 10 subjects (45.5%). Univariate analysis showed statistically significant differences in the assessment of the presence of diabetes and dyslipidemia posttransplantation, but not pretransplantation. Among the patients with CAV there was a higher percentage of diabetics (32.8% vs 12%, P < .01). The patients with CAV also had higher levels of total cholesterol (211 ± 40 mg/dL vs 195 ± 35 mg/dL, P = .02), triglycerides (172 ± 108 mg/dL vs 136 ± 66 mg/dL, P = .03), low-density lipoprotein (133 ± 35 mg/dL vs 117 ± 30 mg/dL, P = .01), and lower high-density lipoprotein levels (46 ± 15 mg/dL vs 52 ± 12 mg/dL, P = .03). Only the diabetes and dyslipidemia present in the posttransplantation period were associated with CAV, which highlights the fact that it is a condition that both shares and has different features with atherosclerosis and probably requires a different diagnostic-therapeutic approach.