title: Do cardiovascular risk factors influence cardiac allograft vasculopathy?
abstract: BACKGROUND
  Cardiac allograft vasculopathy (CAV) is the leading cause of heart transplant failure after the first year. The etiological factors involved are currently a controversial matter. Intravascular ultrasound (IVUS) is considered the diagnostic procedure of choice. We assessed the relationship of cardiovascular risk factors with CAV.
  
  
  METHODS
  We analyzed prospectively 22 patients. We conducted a first study with coronary angiography and IVUS at 36 +/- 3 days and a second at 598 +/- 49 days. We performed an average of 5.6 clinical revisions per patient, assessing the effect of the classic cardiovascular risk factors, the cause of heart failure, and the age of the patient and donor. The statistics used were chi(2), Fisher exact test, and Student t test.
  
  
  RESULTS
  CAV was found in 10 subjects (45.5%). Univariate analysis showed statistically significant differences in the assessment of the presence of diabetes and dyslipidemia posttransplantation, but not pretransplantation. Among the patients with CAV there was a higher percentage of diabetics (32.8% vs 12%, P < .01). The patients with CAV also had higher levels of total cholesterol (211 +/- 40 mg/dL vs 195 +/- 35 mg/dL, P = .02), triglycerides (172 +/- 108 mg/dL vs 136 +/- 66 mg/dL, P = .03), low-density lipoprotein (133 +/- 35 mg/dL vs 117 +/- 30 mg/dL, P = .01), and lower high-density lipoprotein levels (46 +/- 15 mg/dL vs 52 +/- 12 mg/dL, P = .03).
  
  
  CONCLUSIONS
  Only the diabetes and dyslipidemia present in the posttransplantation period were associated with CAV, which highlights the fact that it is a condition that both shares and has different features with atherosclerosis and probably requires a different diagnostic-therapeutic approach.
authors.affiliation: Cardiac Failure and Transplant Unit, La Fe University Hospital, Valencia, Spain. carlosisra@ono.com
authors.forename: C I
authors.initials: CI
authors.lastname: Chamorro
authors.forename: L
authors.initials: L
authors.lastname: Almenar
authors.forename: L
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: E
authors.initials: E
authors.lastname: Sánchez-Lacuesta
authors.forename: J
authors.initials: J
authors.lastname: Martín-Pastor
authors.forename: F
authors.initials: F
authors.lastname: Ten-Morro
authors.forename: R M
authors.initials: RM
authors.lastname: Sánchez-Soriano
authors.forename: J
authors.initials: J
authors.lastname: Agüero
authors.forename: V
authors.initials: V
authors.lastname: Ortiz
authors.forename: J A
authors.initials: JA
authors.lastname: Moro
authors.forename: A
authors.initials: A
authors.lastname: Salvador
mesh_terms: D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D017023:Coronary Angiography; D003920:Diabetes Mellitus / Q000453:epidemiology; D050171:Dyslipidemias / Q000453:epidemiology; D016027:Heart Transplantation / Q000473:pathology*; D006801:Humans; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking; D014184:Transplantation, Homologous / Q000473:pathology; D018084:Ultrasonography, Interventional