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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2004-5-18
pubmed:abstractText
We studied 361 patients, to evaluate risk factors for cardiac allograft vasculopathy (CAV) onset and severity/diffusion in heart transplantation (HT). Rejection scores (RS) on endomyocardial biopsy were calculated (first year and whole follow-up). CAV onset was defined as any lesion seen at yearly angiography. A CAV severity/diffusion index was calculated for each patient summing up the scores of all lesions. Cox multivariate analysis included: donor age, sex, and weight; recipient sex, age, pre-HT diagnosis, hypertension, diabetes and hyperlipidemia post-HT; number of treated rejections and RS; and immunosuppressive dosage at 3, 6, and 12 months. CAV frequency was 2% at 1 year, 22% at 5 and 39% at 10 years. Risk factors for CAV onset were older donor age [p < 0.0001, relative risk (RR) = 9.9], male donor (p < 0.001, RR = 3.2), high RS for severe (> or = 3A) grades (p < 0.02, RR = 2.01), high cyclosporine at 3 months (p < 0.02, RR = 1.9). Risk factors for CAV severity/diffusion were higher donor weight (p < 0.01, RR = 7.5), high prednisone dosage at 1 year (p < 0.0001, RR = 21.1), and coronary disease pre-HT (p < 0.002, RR = 9.7). High RS was an independent predictor for CAV onset, not severity/diffusion. This suggests an immune basis for CAV onset and nonimmune modulation for progression. High RS for severe grades may provide a predictor for patients at risk.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1600-6135
pubmed:author
pubmed:issnType
Print
pubmed:volume
4
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
962-70
pubmed:dateRevised
2007-2-14
pubmed:meshHeading
pubmed-meshheading:15147431-Adult, pubmed-meshheading:15147431-Age of Onset, pubmed-meshheading:15147431-Anti-Inflammatory Agents, pubmed-meshheading:15147431-Body Weight, pubmed-meshheading:15147431-Coronary Angiography, pubmed-meshheading:15147431-Coronary Disease, pubmed-meshheading:15147431-Coronary Vessels, pubmed-meshheading:15147431-Cyclosporine, pubmed-meshheading:15147431-Female, pubmed-meshheading:15147431-Graft Rejection, pubmed-meshheading:15147431-Heart Transplantation, pubmed-meshheading:15147431-Humans, pubmed-meshheading:15147431-Immune Tolerance, pubmed-meshheading:15147431-Immunosuppression, pubmed-meshheading:15147431-Immunosuppressive Agents, pubmed-meshheading:15147431-Male, pubmed-meshheading:15147431-Middle Aged, pubmed-meshheading:15147431-Prednisone, pubmed-meshheading:15147431-Prognosis, pubmed-meshheading:15147431-Risk Factors, pubmed-meshheading:15147431-Transplantation, Homologous
pubmed:year
2004
pubmed:articleTitle
Immune and nonimmune predictors of cardiac allograft vasculopathy onset and severity: multivariate risk factor analysis and role of immunosuppression.
pubmed:affiliation
Department of Cardiology, University of Padua, Padua, Italy. alida.caforio@unipd.it
pubmed:publicationType
Journal Article