作者
Rabea Asleh, Alexandros Briasoulis, Walter K Kremers, Rosalyn Adigun, Barry A Boilson, Naveen L Pereira, Brooks S Edwards, Alfredo L Clavell, John A Schirger, Richard J Rodeheffer, Robert P Frantz, Lyle D Joyce, Simon Maltais, John M Stulak, Richard C Daly, Jonella Tilford, Woong-Gil Choi, Amir Lerman, Sudhir S Kushwaha
发表日期
2018/2/13
期刊
Journal of the American College of Cardiology
卷号
71
期号
6
页码范围
636-650
出版商
American College of Cardiology Foundation
简介
Background
Small studies have reported superiority of sirolimus (SRL) over calcineurin inhibitor (CNI) in mitigating cardiac allograft vasculopathy (CAV) after heart transplantation (HT). However, data on the long-term effect on CAV progression and clinical outcomes are lacking.
Objectives
The aim of this study was to test the long-term safety and efficacy of conversion from CNI to SRL as maintenance therapy on CAV progression and outcomes after HT.
Methods
A cohort of 402 patients who underwent HT and were either treated with CNI alone (n = 134) or converted from CNI to SRL (n = 268) as primary immunosuppression was analyzed. CAV progression was assessed using serial coronary intravascular ultrasound during treatment with CNI (n = 99) and after conversion to SRL (n = 235) in patients who underwent at least 2 intravascular ultrasound studies.
Results
The progression in plaque volume (2.8 ± 2.3 mm3 …
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R Asleh, A Briasoulis, WK Kremers, R Adigun… - Journal of the American College of Cardiology, 2018