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Background: Peripheral arterial disease (PAD) is a risk factor for increased long term mortality following heart transplantation (HT). However, data on the incidence of adverse events, length of hospitalization immediately following HT and long term graft survival time in patients with PAD is limited.
Methods: We retrospectively analyzed the United Network for Organ Sharing (UNOS) database (1988-2014). The endpoints used were incident adverse events prior to hospital discharge following HT. A multivariate logistic regression model was used to assess the independent association of PAD with adverse outcomes.
Results: Among 22,820 adults HT recipients (mean age 52±12 years, men 77%), 820 (3.5%) had underlying symptomatic PAD and 15, 138 patients had incident complications prior to discharge after HT (Table 1). Symptomatic PAD in HT recipients was independently associated with a higher incidence of individual and composite outcomes, driven by a greater incidence of dialysis use, cardiac reoperations and infections (Table 1). HT-recipients with PAD had an inferior mean graft survival time (6.1±4.8 vs. 7.2±4.7 years, p<0.01) and a higher proportion of patients with length of hospital stay above median limits (74% vs. 69%, p=0.04), compared to those without PAD.
Conclusions: Symptomatic PAD confers independent prognostic implications for perioperative adverse events, longer hospital stay and poorer long term graft survival rates following HT, thereby indicating high risk for HT-related morbidity.
Moderated Poster Contributions
Heart Failure and Cardiomyopathies Moderated Poster Theater, Poster Hall, Hall C
Sunday, March 19, 2017, 12:30 p.m.-12:40 p.m.
Session Title: Advanced Therapies = Advanced Trouble: VAD and Transplant Challenges
Abstract Category: 14. Heart Failure and Cardiomyopathies: Therapy
Presentation Number: 1318M-03
- 2017 American College of Cardiology Foundation