Association of angiotensin-converting enzyme inhibitors and serum lipids with plaque regression in cardiac allograft vasculopathy.
We assessed clinical predictors of the process of cardiac allograft vasculopathy (CAV) in 39 consecutive patients (mean 49 years old) using three-dimensional intravascular ultrasound (3-D IVUS) examination of the left anterior descending coronary artery at 36 +/- 38 months and 47 +/- 40 months after cardiac allotransplantation (TX). Compared with 17 patients with plaque progression, 22 patients with plaque regression were more likely to be male (P < .01), to have a higher use of angiotensin-converting enzyme inhibitors (ACEI, P < .05), and to have a lower volumetric remodeling index (P < .001). The changes in plaque volume correlated with the changes in total cholesterol (P < .005) and low-density lipoprotein cholesterol (P < .02). Plaque progression of CAV was independently associated with time after TX, hypertension, nonuse of ACEI, donor age, and changes in total cholesterol and triglycerides. In conclusion, plaque progression is associated with positive vascular remodeling and plaque regression is associated with lower serum lipids and ACEI in patients after TX.
Bae
Jang-Ho
JH
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN 55905, USA.
Rihal
Charanjit S
CS
Edwards
Brooks S
BS
Kushwaha
Sudhir S
SS
Mathew
Verghese
V
Prasad
Abhiram
A
Holmes
David R
DR
Lerman
Amir
A
D000328:Adult; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D000924:Anticholesteremic Agents / Q000494:pharmacology; D008078:Cholesterol, LDL / Q000378:metabolism; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000473:pathology*; D003331:Coronary Vessels / Q000473:pathology*; D018450:Disease Progression; D050171:Dyslipidemias / Q000188:drug therapy / Q000473:pathology; D004791:Enzyme Inhibitors / Q000494:pharmacology; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged
D000806:Angiotensin-Converting Enzyme Inhibitors; D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D004791:Enzyme Inhibitors; D008055:Lipids