Long-Term Prognostic Value of Coronary CTA in Orthotopic Heart Transplant Recipients
This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients. The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculop...
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| Veröffentlicht in: | American journal of roentgenology (1976) 2021-05, Vol.216 (5), p.1216-1221 |
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| container_title | American journal of roentgenology (1976) |
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| creator | García-Baizán, Alejandra Caballeros, Meylin Ezponda, Ana Manrique, Rebeca Gavira, Juan J Rábago, Gregorio Bastarrika, Gorka |
| description | This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients.
The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction ≥ 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared.
Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 ± 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (
< .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7-21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95-13;
=. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS ≥ 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46-8.23).
In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs. |
| doi_str_mv | 10.2214/AJR.20.23535 |
| format | Article |
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The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction ≥ 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared.
Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 ± 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (
< .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7-21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95-13;
=. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS ≥ 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46-8.23).
In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs.</description><identifier>ISSN: 0361-803X</identifier><identifier>EISSN: 1546-3141</identifier><identifier>DOI: 10.2214/AJR.20.23535</identifier><identifier>PMID: 33624522</identifier><language>eng</language><publisher>United States</publisher><subject>Aged ; Computed Tomography Angiography - methods ; Coronary Angiography - methods ; Coronary Artery Disease - diagnostic imaging ; Female ; Heart - diagnostic imaging ; Heart Transplantation ; Humans ; Male ; Middle Aged ; Postoperative Complications - diagnostic imaging ; Predictive Value of Tests ; Prognosis ; Retrospective Studies</subject><ispartof>American journal of roentgenology (1976), 2021-05, Vol.216 (5), p.1216-1221</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c334t-7dce52d1fced57ce4a1c97d55086c7052e2e1c2490650491211c44401c4a9eae3</citedby><cites>FETCH-LOGICAL-c334t-7dce52d1fced57ce4a1c97d55086c7052e2e1c2490650491211c44401c4a9eae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,4105,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33624522$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>García-Baizán, Alejandra</creatorcontrib><creatorcontrib>Caballeros, Meylin</creatorcontrib><creatorcontrib>Ezponda, Ana</creatorcontrib><creatorcontrib>Manrique, Rebeca</creatorcontrib><creatorcontrib>Gavira, Juan J</creatorcontrib><creatorcontrib>Rábago, Gregorio</creatorcontrib><creatorcontrib>Bastarrika, Gorka</creatorcontrib><title>Long-Term Prognostic Value of Coronary CTA in Orthotopic Heart Transplant Recipients</title><title>American journal of roentgenology (1976)</title><addtitle>AJR Am J Roentgenol</addtitle><description>This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients.
The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction ≥ 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared.
Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 ± 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (
< .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7-21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95-13;
=. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS ≥ 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46-8.23).
In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs.</description><subject>Aged</subject><subject>Computed Tomography Angiography - methods</subject><subject>Coronary Angiography - methods</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Female</subject><subject>Heart - diagnostic imaging</subject><subject>Heart Transplantation</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Postoperative Complications - diagnostic imaging</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><issn>0361-803X</issn><issn>1546-3141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kD1PwzAQhi0EoqWwMSOPDATOX_kYqwooqFJRFRBbZJxLCUriYCcD_x5XLSx3Nzz36u4h5JLBLedM3s2fN7c8zEIJdUSmTMk4EkyyYzIFEbMoBfE-IWfefwFAkmbJKZkIEXOpOJ-SfGW7bZSja-mLs9vO-qE29E03I1Jb0YV1ttPuhy7yOa07unbDpx1sH5glajfQ3OnO943uBrpBU_c1doM_JyeVbjxeHPqMvD7c54tltFo_Pi3mq8gIIYcoKQ0qXrLKYKkSg1IzkyWlUpDGJgHFkSMzXGYQK5AZ44wZKSWEqjPUKGbkep_bO_s9oh-KtvYGm3AO2tEXYVUAxClAQG_2qHHWe4dV0bu6DZ8VDIqdxyJ4LHiYdx4DfnVIHj9aLP_hP3HiFwNHbLw</recordid><startdate>202105</startdate><enddate>202105</enddate><creator>García-Baizán, Alejandra</creator><creator>Caballeros, Meylin</creator><creator>Ezponda, Ana</creator><creator>Manrique, Rebeca</creator><creator>Gavira, Juan J</creator><creator>Rábago, Gregorio</creator><creator>Bastarrika, Gorka</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202105</creationdate><title>Long-Term Prognostic Value of Coronary CTA in Orthotopic Heart Transplant Recipients</title><author>García-Baizán, Alejandra ; Caballeros, Meylin ; Ezponda, Ana ; Manrique, Rebeca ; Gavira, Juan J ; Rábago, Gregorio ; Bastarrika, Gorka</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c334t-7dce52d1fced57ce4a1c97d55086c7052e2e1c2490650491211c44401c4a9eae3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Computed Tomography Angiography - methods</topic><topic>Coronary Angiography - methods</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Female</topic><topic>Heart - diagnostic imaging</topic><topic>Heart Transplantation</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Postoperative Complications - diagnostic imaging</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>García-Baizán, Alejandra</creatorcontrib><creatorcontrib>Caballeros, Meylin</creatorcontrib><creatorcontrib>Ezponda, Ana</creatorcontrib><creatorcontrib>Manrique, Rebeca</creatorcontrib><creatorcontrib>Gavira, Juan J</creatorcontrib><creatorcontrib>Rábago, Gregorio</creatorcontrib><creatorcontrib>Bastarrika, Gorka</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>American journal of roentgenology (1976)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>García-Baizán, Alejandra</au><au>Caballeros, Meylin</au><au>Ezponda, Ana</au><au>Manrique, Rebeca</au><au>Gavira, Juan J</au><au>Rábago, Gregorio</au><au>Bastarrika, Gorka</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Prognostic Value of Coronary CTA in Orthotopic Heart Transplant Recipients</atitle><jtitle>American journal of roentgenology (1976)</jtitle><addtitle>AJR Am J Roentgenol</addtitle><date>2021-05</date><risdate>2021</risdate><volume>216</volume><issue>5</issue><spage>1216</spage><epage>1221</epage><pages>1216-1221</pages><issn>0361-803X</issn><eissn>1546-3141</eissn><abstract>This study aimed to evaluate the long-term prognostic value of coronary CTA (CCTA) in heart transplant recipients.
The records of 114 patients who had undergone a heart transplant (mean age, 61.7 ± 11.1 [SD] years; 83.3% men) and who underwent CCTA for the surveillance of coronary allograft vasculopathy (CAV) from June 2007 to December 2017 were retrospectively evaluated for the occurrence of major adverse cardiovascular events (MACEs) (cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, coronary revascularization, cardiac arrhythmias, stroke, and retransplant). Patients were classified according to the presence of nonobstructive CAV (lumen reduction < 50%) or obstructive disease (lumen reduction ≥ 50%) and using a coronary segment involvement score (SIS). Differences in MACE rate between groups were compared.
Obstructive CAV was observed in 12 heart transplant recipients (10.5%). During a mean follow-up of 67.5 ± 41.4 months the overall rates of MACE were 50% and 14.7% in patients with obstructive and nonobstructive CAV, respectively (
< .05), resulting in an odds ratio for MACE of 6 (95% CI, 1.7-21.2). Comparison of event-free survival showed a hazard ratio (HR) of 5 (95% CI, 1.95-13;
=. 004) for patients with obstructive disease. The presence of four or more stenotic coronary segments (SIS ≥ 4) was associated with a higher rate of events (HR, 3.46; 95% CI, 1.46-8.23).
In patients who have undergone a heart transplant, CCTA offers a significant long-term prognostic impact on the prediction of MACEs.</abstract><cop>United States</cop><pmid>33624522</pmid><doi>10.2214/AJR.20.23535</doi><tpages>6</tpages></addata></record> |
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| source | American Roentgen Ray Society; MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Computed Tomography Angiography - methods Coronary Angiography - methods Coronary Artery Disease - diagnostic imaging Female Heart - diagnostic imaging Heart Transplantation Humans Male Middle Aged Postoperative Complications - diagnostic imaging Predictive Value of Tests Prognosis Retrospective Studies |
| title | Long-Term Prognostic Value of Coronary CTA in Orthotopic Heart Transplant Recipients |
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