Tarun W Dasari1, Jorge F Saucedo2, Selim Krim3, Mohamad Alkhouli4, Gregg C Fonarow5, Rene Alvarez4, Homam Ibrahim6, David Dai7, Tracy Y Wang7, Marco Costa8, JoAnn Lindenfeld9, John C Messenger10. 1. Division of Cardiology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Electronic address: tarun-dasari@ouhsc.edu. 2. Division of Cardiology, Northshore University Health System, Evanston, IL. 3. John Ochsner Heart and Vascular Institute, Ochsner Clinic Foundation, New Orleans, LA. 4. Cardiovascular Division, Temple University, Philadelphia, PA. 5. Ahmanson-UCLA Cardiomyopathy Center, Ronald Reagan-UCLA Medical Center, Los Angeles, CA. 6. Division of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX. 7. Duke University Medical Center and Duke Clinical Research Institute (DCRI), Durham, NC. 8. Division of Cardiovascular Medicine; UH Case Medical Center, Case Western Reserve University in Cleveland, OH. 9. Vanderbilt University, Nashville, TN. 10. Division of Cardiology, University of Colorado School of Medicine, Aurora, CO.
Abstract
BACKGROUND: Cardiac allograft vasculopathy is a major cause of morbidity and mortality following heart transplantation. Large multicenter studies evaluating the clinical characteristics and inhospital outcomes of heart transplant recipients undergoing percutaneous coronary intervention (PCI) are lacking. OBJECTIVE: To evaluate the clinical characteristics, treatment patterns and inhospital outcomes of heart transplant recipients undergoing PCI compared to general population. METHODS: We analyzed 1,897,328 patients from the National Cardiovascular Data Registry CathPCI registry who underwent PCI of at least 1 native vessel between July 2009 and December 2013 from 1,477 centers, of which 542 patients (0.03%) were heart transplant recipients. Clinical characteristics were evaluated and, after 1:4 propensity matching, inhospital outcomes were compared between 538 heart transplant patients and 2,128 non-transplant patients. RESULTS: Transplant recipients undergoing PCI had a higher prevalence of diabetes, dyslipidemia and peripheral vascular disease; lower prevalence of angina, acute coronary syndrome, abnormal noninvasive functional study, and type C coronary lesions compared to the non-transplant PCI population. After propensity matching, all-cause inhospital mortality was similar between transplant and non-transplant groups (1.3% vs 1.0%; OR, 1.21; 95% CI, 0.54-2.67). CONCLUSION: This is the largest series to date outlining the characteristics of heart transplant recipients undergoing PCI. Similar inhospital outcomes were noted in heart transplant recipients compared to the general population. Further studies evaluating long-term outcomes are warranted.
BACKGROUND:Cardiac allograft vasculopathy is a major cause of morbidity and mortality following heart transplantation. Large multicenter studies evaluating the clinical characteristics and inhospital outcomes of heart transplant recipients undergoing percutaneous coronary intervention (PCI) are lacking. OBJECTIVE: To evaluate the clinical characteristics, treatment patterns and inhospital outcomes of heart transplant recipients undergoing PCI compared to general population. METHODS: We analyzed 1,897,328 patients from the National Cardiovascular Data Registry CathPCI registry who underwent PCI of at least 1 native vessel between July 2009 and December 2013 from 1,477 centers, of which 542 patients (0.03%) were heart transplant recipients. Clinical characteristics were evaluated and, after 1:4 propensity matching, inhospital outcomes were compared between 538 heart transplant patients and 2,128 non-transplant patients. RESULTS: Transplant recipients undergoing PCI had a higher prevalence of diabetes, dyslipidemia and peripheral vascular disease; lower prevalence of angina, acute coronary syndrome, abnormal noninvasive functional study, and type C coronary lesions compared to the non-transplant PCI population. After propensity matching, all-cause inhospital mortality was similar between transplant and non-transplant groups (1.3% vs 1.0%; OR, 1.21; 95% CI, 0.54-2.67). CONCLUSION: This is the largest series to date outlining the characteristics of heart transplant recipients undergoing PCI. Similar inhospital outcomes were noted in heart transplant recipients compared to the general population. Further studies evaluating long-term outcomes are warranted.
Authors: Maral Bakir; Nicholas J Jackson; Simon X Han; Alex Bui; Eleanor Chang; David A Liem; Abbas Ardehali; Reza Ardehali; Arnold S Baas; Marcella Calfon Press; Daniel Cruz; Mario C Deng; Eugene C DePasquale; Gregg C Fonarow; Tam Khuu; Murray H Kwon; Bernard M Kubak; Ali Nsair; Jennifer L Phung; Elaine F Reed; Joanna M Schaenman; Richard J Shemin; Qiuheng J Zhang; Chi-Hong Tseng; Martin Cadeiras Journal: J Heart Lung Transplant Date: 2018-03-22 Impact factor: 10.247
Authors: Joe X Xie; Jon A Kobashigawa; Kevin F Kennedy; Timothy D Henry; Steven W Tabak; Robert Krebbs; Leslee Shaw; J Dawn Abbott; Wendy Book; S Tanveer Rab; John A Spertus; Abhinav Goyal Journal: JAMA Cardiol Date: 2020-06-01 Impact factor: 14.676