Percutaneous coronary interventions with stents in cardiac transplant recipients.
BACKGROUND
Allograft coronary vasculopathy is a major cause of death beyond the first year after cardiac transplantation. The aim of this study was to review our experience with percutaneous coronary intervention (PCI) with stents in cardiac transplant recipients.


METHODS
We identified patients who were treated with PCI using stents. Patient characteristics, procedure information and clinical outcomes were assessed for these patients by review of their medical records. We also compared results for those who had bare metal stents vs those who had drug-eluting stents.


RESULTS
Forty patients from our program's 865 cardiac transplant recipients received a total of 78 coronary stents. There were 35 males (87.5%) and 5 females (12.5%). The indication for PCI was progressive asymptomatic coronary vasculopathy in 18 patients (45%), angina in 5 (12.5%), acute myocardial infarction (MI) in 4 (10%) and congestive heart failure (CHF) in 6 (15%). Primary success (<50% residual stenosis) was obtained in 71 (91%) of 78 stents. During the mean follow-up of 40.8 +/- 34.5 months, 6 patients died (15%) and 2 (5%) were re-transplanted. There was a lower rate of re-stenosis with drug-eluting stents (2 of 13, 15%) compared with bare metal stents (20 of 65, 31%), although this difference was not statistically significant (p = 0.27).


CONCLUSIONS
In cardiac transplant recipients, PCI with stents can be performed with high rates of primary success. Restenosis rates are higher compared with PCI in native coronary arteries. A trend toward less restenosis with drug-eluting stents was observed, which needs to be confirmed in larger studies.
Bader
Feras M
FM
Department of Cardiology, University of Utah School of Medicine, Salt Lake City, Utah 84132, USA. ferasbader@hsc.utah.edu
Kfoury
Abdallah G
AG
Gilbert
Edward M
EM
Barry
William H
WH
Humayun
Naeem
N
Hagan
Mary E
ME
Thomas
Heidi
H
Renlund
Dale
D
D015906:Angioplasty, Balloon, Coronary; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000517:prevention & control; D003586:Cytomegalovirus Infections / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D012086:Reoperation; D012189:Retrospective Studies; D020123:Sirolimus / Q000627:therapeutic use; D015607:Stents
D020123:Sirolimus