Cardiac Allograft Vasculopathy by Intravascular Ultrasound in Heart Transplant Patients
| Autor: | Heather J. Ross, Jon A. Kobashigawa, James A. Hill, Randall C. Starling, Patricia Lopez, Howard J. Eisen, Shoei-Shen Wang, Stephen J. Nicholls, Bernard Cantin, Gaohong Dong, A Ivus Substudy Investigators, Daniel F. Pauly |
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| Rok vydání: | 2013 |
| Předmět: |
Heart transplantation
medicine.medical_specialty Everolimus medicine.diagnostic_test business.industry medicine.medical_treatment Urology Cardiomyopathy medicine.disease law.invention Surgery Transplantation surgical procedures operative Randomized controlled trial law Heart failure Multicenter trial Intravascular ultrasound cardiovascular system medicine Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | JACC: Heart Failure. 1:389-399 |
| ISSN: | 2213-1779 |
| Popis: | Objectives A pre-planned substudy of a larger multicenter randomized trial was undertaken to compare the efficacy of everolimus with reduced-dose cyclosporine in the prevention of cardiac allograft vasculopathy (CAV) after heart transplantation to that of mycophenolate mofetil (MMF) with standard-dose cyclosporine. Background CAV is a major cause of long-term mortality following heart transplantation. Everolimus has been shown to reduce the severity and incidence of CAV as measured by first year intravascular ultrasound (IVUS). MMF, in combination with cyclosporine, has also been shown to have a beneficial effect in slowing the progression of CAV. Methods Study patients were a pre-specified subgroup of the 553-patient Everolimus versus mycophenolate mofetil in heart transplantation: a randomized, multicenter trial who underwent heart transplantation and were randomized to everolimus 1.5 mg or MMF 3 g/day. IVUS was performed at baseline and at 12 months. Evaluable IVUS data were available in 189 patients (34.6%). Results Increase in average maximal intimal thickness (MIT) from baseline to month 12 was significantly smaller in the everolimus 1.5 mg group compared with the MMF group (0.03 mm vs. 0.07 mm, p Conclusions Everolimus was significantly more efficacious than MMF in preventing CAV as measured by IVUS among heart-transplant recipients after 1 year, a finding, which was maintained in a range of patient subpopulations. CV surgery: transplantation, ventricular assistance, cardiomyopathy |
| Databáze: | OpenAIRE |
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