PMID- 20534308
OWN - NLM
STAT- MEDLINE
DCOM- 20101029
LR  - 20151119
IS  - 1873-2623 (Electronic)
IS  - 0041-1345 (Linking)
VI  - 42
IP  - 4
DP  - 2010 May
TI  - Lower homocysteine levels in renal transplant recipients treated with everolimus: 
      a possible link with a decreased cardiovascular risk?
PG  - 1381-2
LID - 10.1016/j.transproceed.2010.03.112 [doi]
AB  - Cardiovascular disease (CVD) is the main cause of morbidity and mortality in 
      renal transplant recipients. The incidence of CVD in this setting is 
      approximately 5-fold greater than in age- and and gender-matched subjects. This 
      excess cardiovascular risk is not completely explained by traditional cardiac 
      risk factors. It has been well documented that these patients show greatly 
      increased prevalence of both fasting and postmethionine-loading 
      hyperhomocysteinemia (hHcy) compared with the general population. An 
      immunosuppressive therapy based on everolimus has been demonstrated to reduce the 
      incidence major adverse coronary events at 4 years compared with azathioprine 
      among heart transplant recipients. In contrast, scarce data are available on the 
      impact of everolimus on emerging risk factors, such as homocysteine (Hcy), in 
      renal transplant recipients. The aim of this study was to evaluate the possible 
      impact of everolimus compared with other immunosuppressive regimes among 132 
      stable recipients, including 91 men and 41 women who were at least 1 year after 
      transplant with stable renal function and no clinical evidence of acute or 
      chronic renal graft rejections. We compared 31 subjects on everolimus 
      immunosuppressive therapy (group A) versus 101 on immunosuppressive therapy based 
      on cyclosporine, steroids, and mycophenolate. The Hcy levels were significantly 
      lower among group A patients compared with group B: 16.5 +/- 5 micromol/L vs 21.2 
      +/- 11 micromol/L; P < .005. Hyper-Hcy, defined as Hcy levels >15 micromol/L, was 
      diagnosed in 18 out of 31 patients (51%) of group A and in 82 out of 101 patients 
      (81%) of group B. This preliminary study demonstrates a favorable impact of 
      everolimus on a marker of atherothrombosis which is associated with a worse 
      vascular prognosis.
CI  - Copyright (c) 2010. Published by Elsevier Inc.
FAU - Farsetti, S
AU  - Farsetti S
AD  - Renal Unit, Careggi University Hospital, Florence, Italy. 
      silvia.farsetti@email.it
FAU - Zanazzi, M
AU  - Zanazzi M
FAU - Caroti, L
AU  - Caroti L
FAU - Rosso, G
AU  - Rosso G
FAU - Larti, A
AU  - Larti A
FAU - Marcucci, R
AU  - Marcucci R
FAU - Fedi, S
AU  - Fedi S
FAU - Rogolino, A
AU  - Rogolino A
FAU - Cellai, A P
AU  - Cellai AP
FAU - Abbate, R
AU  - Abbate R
FAU - Bertoni, E
AU  - Bertoni E
FAU - Salvadori, M
AU  - Salvadori M
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Transplant Proc
JT  - Transplantation proceedings
JID - 0243532
RN  - 0 (Immunosuppressive Agents)
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 9HW64Q8G6G (Everolimus)
RN  - W36ZG6FT64 (Sirolimus)
SB  - IM
MH  - Cardiovascular Diseases/etiology/prevention & control
MH  - Drug Therapy, Combination
MH  - Everolimus
MH  - Female
MH  - Homocysteine/*blood
MH  - Humans
MH  - Immunosuppressive Agents/*therapeutic use
MH  - Kidney Transplantation/adverse effects/*immunology/physiology
MH  - Male
MH  - Postoperative Complications/prevention & control
MH  - Sirolimus/*analogs & derivatives/therapeutic use
EDAT- 2010/06/11 06:00
MHDA- 2010/10/30 06:00
CRDT- 2010/06/11 06:00
PHST- 2010/06/11 06:00 [entrez]
PHST- 2010/06/11 06:00 [pubmed]
PHST- 2010/10/30 06:00 [medline]
AID - S0041-1345(10)00448-3 [pii]
AID - 10.1016/j.transproceed.2010.03.112 [doi]
PST - ppublish
SO  - Transplant Proc. 2010 May;42(4):1381-2. doi: 10.1016/j.transproceed.2010.03.112.