Author + information
- Maxime Tremblay-Gravel,
- Normand Racine,
- Anique Ducharme,
- Guy Pelletier,
- Genevieve Giraldeau,
- Mark Liszkowski,
- Marie-Claude Parent,
- Michel Carrier,
- Annik Fortier and
- Michel White
Background: Limited data have suggested that the International Society for Heart and Lung Transplantation (ISHLT) classification for coronary allograft vasculopathy (CAV) may predict outcomes. The temporal changes of CAV prognosis have been incompletely investigated.
Methods: Heart transplant (HTx) recipients at the Montreal Heart Institute who underwent a coronary angiography within 3 years of HTx were classified according to the severity of CAV (absent, CAV 0 ; mild, CAV 1; moderate and severe, CAV 2 and 3) and era of HTx (early, 1983-1998 ; recent, 1999-2011). We compared prevalence, progression and survival among groups.
Results: A total of 298 patients were followed for a mean of 11.6 ± 6.6 years. The early era was associated with a higher prevalence of CAV at 5 years when compared to the recent era (38% vs 23% ; P=0.020), and a higher risk of progression from CAV 1 to a higher grade (OR 8.0, 95% CI 1.0 to 63.0). In the early era, any grade of CAV was associated with a significant increase in total mortality (HR 1.6, 95% CI 1.1 to 2.5), but not in the recent era (HR 1.1, 95% CI 0.2 to 4.9). Regardless of the era, CAV 2-3 and CAV 1 were associated with a significant increase in total mortality compared to CAV 0 using multivariate Cox regression analyses considering baseline covariates (HR 6.5, 95% CI 2.7 to 15.7 ; and HR 1.7, 95% CI 1.0 to 3.0, respectively).
Conclusions: Over 25 years, the prevalence, progression and prognosis of CAV have improved. The ISHLT CAV nomenclature accurately and independently predicts prognosis.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: The Evolving World of LVADs, Transplant and Other Novel Discoveries
Abstract Category: 13. Heart Failure and Cardiomyopathies: Clinical
Presentation Number: 1294-273
- 2017 American College of Cardiology Foundation