Clinical characteristics and in hospital outcomes of heart transplant recipients with allograft vasculopathy undergoing percutaneous coronary intervention: Insights from the National Cardiovascular Data Registry

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• 作者：Tarun W. Dasari ; MD ; MPH^a ; ^{tarun-dasari@ouhsc.edu" class="auth_mail" title="E-mail the corresponding author} ; Jorge F. Saucedo ; MD^b ; Selim Krim ; MD^c ; Mohamad Alkhouli ; MD^d ; Gregg C. Fonarow ; MD^e ; Rene Alvarez ; MD^d ; Homam Ibrahim ; MD^f ; David Dai ; PhD^g ; Tracy Y. Wang ; MD ; MHS ; MSc^g ; Marco Costa ; MD^h ; JoAnn Lindenfeld ; MDⁱ ; John C. Messenger ; MD^j
• 刊名：American Heart Journal
• 出版年：2015
• 出版时间：December 2015
• 年：2015
• 卷：170
• 期：6
• 页码：1086-1091
• 全文大小：315 K

文摘

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.