Vascular antithrombin and clinical outcome in heart transplant patients

A procoagulant microvasculature is associated with accelerated development of coronary artery disease (CAD) and failure in heart transplant patients. This study was performed to evaluate how changes in natural anticoagulation within cardiac allografts affect outcome. We prospectively studied 141 con...

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Bibliographic Details
Published in:The American journal of cardiology 2001-02, Vol.87 (4), p.425-431
Main Authors: Labarrere, Carlos A, Torry, Ronald J, Nelson, David R, Miller, Steven J, Pitts, Douglas E, Kirlin, Philip C, Halbrook, Harold G
Format: Article
Language:English
Subjects:
Antithrombins - metabolism
Biological and medical sciences
Biopsy
Clinical outcomes
Coronary Angiography
Coronary Disease - etiology
Graft Rejection - etiology
Heart
Heart Transplantation
Humans
Immunohistochemistry
Logistic Models
Medical sciences
Myocardium - metabolism
Myocardium - pathology
Patients
Proportional Hazards Models
Prospective Studies
Statistics, Nonparametric
Studies
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the heart
Survival Analysis
Transplants & implants
Treatment Outcome
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Summary:A procoagulant microvasculature is associated with accelerated development of coronary artery disease (CAD) and failure in heart transplant patients. This study was performed to evaluate how changes in natural anticoagulation within cardiac allografts affect outcome. We prospectively studied 141 consecutive cardiac allograft recipients who underwent transplantation between 1988 and 1997. Serial endomyocardial biopsy specimens (6.5 ± 0.1 biopsy specimens/patient) obtained during the first 3 months after transplantation were studied immunohistochemically to evaluate vascular antithrombin, and annual coronary angiograms (3.8 ± 0.2 angiograms/patient) were studied to evaluate CAD. Antithrombin was present in arteries and veins, but not in capillaries, of all donor heart biopsy samples. Allografts that maintained vascular antithrombin had the best prognosis. Allografts with early and persistent loss of vascular antithrombin (n = 21) developed CAD earlier (p
ISSN:0002-9149
1879-1913
DOI:10.1016/S0002-9149(00)01395-3