PMID- 9294668
OWN - NLM
STAT- MEDLINE
DCOM- 19971020
LR  - 20200225
IS  - 0160-9289 (Print)
IS  - 1932-8737 (Electronic)
IS  - 0160-9289 (Linking)
VI  - 20
IP  - 9
DP  - 1997 Sep
TI  - The risk of coronary artery disease after heart transplantation is increased in 
      patients receiving low-dose cyclosporine, regardless of blood cyclosporine 
      levels.
PG  - 767-72
AB  - BACKGROUND: Coronary artery disease (CAD) of allografted hearts is the main cause 
      of late mortality after cardiac transplant, but its etiology is still 
      undetermined. HYPOTHESIS: This study was undertaken to evaluate the relevance of 
      several risk factors, including cyclosporine (CsA) dose and blood CsA levels, to 
      the incidence of CAD. METHODS: In 163 heart transplants performed between 
      November 1985 and August 1994 at our Institution, CAD was diagnosed by coronary 
      angiography or at postmortem examination. Patients in whom postmortem examination 
      or coronary angiography was not performed, as well as those < 15 years of age and 
      those who died within 1 month of surgery, were excluded from the study. The 
      following risk factors were analyzed: recipient age, gender, pretransplant 
      diagnosis, donor age, number of human leukocyte antigen (HLA)-AB mismatches, 
      cytomegalovirus serology, mear serum cholesterol and triglyceride levels, the 
      number of treated acute rejections, mean weighted CsA dose (CsA dosew and 
      weighted blood CsA levels (blood CsA levelw). RESULTS: Coronary artery disease 
      was diagnosed in 32 patients (19.6%). A low mean CsA dosew was the only 
      significant predictor for CAD at multivariate analysis (p < 0.01): there was no 
      correlation with blood CsA levelw. In the patients receiving a CsA dosew > 4 
      mg/kg/day, the 8.9 year probability of their remaining CAD free was 69% 
      [confidence interval (CI) 50-87%] in comparison with 31% (CI 0-65%) in patients 
      receiving a CsA dosew < 4 mg/kg/day. CONCLUSION: In our experience, a low CsA 
      maintenance dose is the main risk factor for CAD, irrespective of blood CsA 
      levels.
FAU - Gamba, A
AU  - Gamba A
AD  - Department of Cardiac Surgery, Ospedali Riuniti di Bergamo, Italy.
FAU - Mamprin, F
AU  - Mamprin F
FAU - Fiocchi, R
AU  - Fiocchi R
FAU - Senni, M
AU  - Senni M
FAU - Troise, G
AU  - Troise G
FAU - Ferrazzi, P
AU  - Ferrazzi P
FAU - Ferrara, R
AU  - Ferrara R
FAU - Corbetta, G
AU  - Corbetta G
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - United States
TA  - Clin Cardiol
JT  - Clinical cardiology
JID - 7903272
RN  - 0 (Immunosuppressive Agents)
RN  - 83HN0GTJ6D (Cyclosporine)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Coronary Disease/*chemically induced/diagnosis/epidemiology
MH  - Cyclosporine/*administration & dosage/blood
MH  - Dose-Response Relationship, Drug
MH  - Female
MH  - Follow-Up Studies
MH  - Graft Rejection/*blood/diagnosis/prevention & control
MH  - *Heart Transplantation
MH  - Humans
MH  - Immunosuppressive Agents/*administration & dosage/blood
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Survival Rate
PMC - PMC6655631
EDAT- 1997/09/19 00:00
MHDA- 1997/09/19 00:01
PMCR- 2009/02/03
CRDT- 1997/09/19 00:00
PHST- 1997/09/19 00:00 [pubmed]
PHST- 1997/09/19 00:01 [medline]
PHST- 1997/09/19 00:00 [entrez]
PHST- 2009/02/03 00:00 [pmc-release]
AID - CLC4960200911 [pii]
AID - 10.1002/clc.4960200911 [doi]
PST - ppublish
SO  - Clin Cardiol. 1997 Sep;20(9):767-72. doi: 10.1002/clc.4960200911.