PMID- 18187082
OWN - NLM
STAT- MEDLINE
DCOM- 20080131
LR  - 20161124
IS  - 1557-3117 (Electronic)
IS  - 1053-2498 (Linking)
VI  - 27
IP  - 1
DP  - 2008 Jan
TI  - A decade of percutaneous coronary interventions in cardiac transplant recipients: 
      a monocentric study in 160 patients.
PG  - 17-25
LID - 10.1016/j.healun.2007.10.007 [doi]
AB  - BACKGROUND: Transplant vasculopathy is a long-term complication of cardiac 
      transplantation. Percutaneous transluminal coronary angioplasty (PCI) is a method 
      of choice for local revascularization that is also increasingly used in heart 
      transplant patients. METHODS: Between October 1989 and November 2006, 160 adult 
      cardiac transplant recipients (19 women) with mean age at heart transplantation 
      of 47 +/- 12 years underwent PCI in 502 coronary segments during 319 
      catheterizations (balloon only, 209; bare metal stents, 227, drug-eluting stents, 
      66). Concomitant medical therapy, procedural data, primary success, recurrence of 
      stenosis, and cardiac events (cardiac death or repeat transplantation) were 
      analyzed retrospectively. Multivariate Cox proportional hazards analysis was 
      performed. RESULTS: Stents reduced early and mid-term recurrence of stenosis but 
      had no impact on graft survival. Drug-eluting stents did not improve the 
      restenosis rate. Immunosuppression with mycophenolate mofetil and concomitant 
      treatment with statins and clopidogrel were significantly associated with reduced 
      recurrence of stenosis and prolonged graft survival. Low steroid dosage was 
      associated with a positive impact on graft survival. CONCLUSIONS: Stenting in 
      heart transplant patients has no impact on graft survival despite high primary 
      success and deferred recurrence of stenosis. Early reduction of steroids, 
      immunosuppression by mycophenolate mofetil, and concomitant treatment with 
      statins are likely to reduce recurrent stenosis and to improve graft survival in 
      heart transplant patients needing PCI. Long-term treatment with clopidogrel 
      deserves further assessment.
FAU - Wellnhofer, Ernst
AU  - Wellnhofer E
AD  - Department of Internal Medicine/Cardiology, Deutsches Herzzentrum Berlin, Berlin, 
      Germany. Ewellnhofer@t-online.de
FAU - Hiemann, Nicola E
AU  - Hiemann NE
FAU - Hug, Jurgen
AU  - Hug J
FAU - Dreysse, Stefan
AU  - Dreysse S
FAU - Knosalla, Christoph
AU  - Knosalla C
FAU - Graf, Kristof
AU  - Graf K
FAU - Meyer, Rudolph
AU  - Meyer R
FAU - Lehmkuhl, Hans B
AU  - Lehmkuhl HB
FAU - Hetzer, Roland
AU  - Hetzer R
FAU - Fleck, Eckart
AU  - Fleck E
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Heart Lung Transplant
JT  - The Journal of heart and lung transplantation : the official publication of the 
      International Society for Heart Transplantation
JID - 9102703
RN  - 0 (Coated Materials, Biocompatible)
RN  - 0 (Immunosuppressive Agents)
SB  - IM
MH  - Angioplasty, Balloon, Coronary/*methods/statistics & numerical data
MH  - Blood Vessel Prosthesis Implantation/*methods/statistics & numerical data
MH  - Coated Materials, Biocompatible
MH  - Coronary Angiography
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Occlusion, Vascular/diagnostic imaging/etiology/*therapy
MH  - Graft Rejection/drug therapy
MH  - *Heart Transplantation
MH  - Humans
MH  - Immunosuppressive Agents/therapeutic use
MH  - Male
MH  - Middle Aged
MH  - Proportional Hazards Models
MH  - Retrospective Studies
MH  - Stents
MH  - Time Factors
MH  - Treatment Outcome
EDAT- 2008/01/12 09:00
MHDA- 2008/02/01 09:00
CRDT- 2008/01/12 09:00
PHST- 2007/07/26 00:00 [received]
PHST- 2007/10/09 00:00 [revised]
PHST- 2007/10/09 00:00 [accepted]
PHST- 2008/01/12 09:00 [pubmed]
PHST- 2008/02/01 09:00 [medline]
PHST- 2008/01/12 09:00 [entrez]
AID - S1053-2498(07)00776-0 [pii]
AID - 10.1016/j.healun.2007.10.007 [doi]
PST - ppublish
SO  - J Heart Lung Transplant. 2008 Jan;27(1):17-25. doi: 10.1016/j.healun.2007.10.007.