title: Re-stenosis after drug-eluting stents in cardiac allograft vasculopathy.
abstract: BACKGROUND
  Cardiac allograft vasculopathy (CAV) constitutes a primary cause of death after heart transplantation. Balloon angioplasty and bare metal stents have been used for revascularization but they are associated with a high risk of re-stenosis. Limited data have shown favorable results with drug-eluting stents (DES). This study examines the rate of re-stenosis for DES in CAV as well as predictors for its occurrence.
  
  
  METHODS
  Cardiac transplant patients who received at least one DES for a previously untreated coronary lesion were included. These patients were retrospectively followed until February 2007. Re-stenosis was defined as >or=50% lumen diameter narrowing on coronary angiography at the site of the DES.
  
  
  RESULTS
  During the study period, 35 patients underwent percutaneous coronary intervention (PCI) on a total of 84 de novo lesions. The mean follow-up was 22 +/- 14 months. Twenty-six (31%) lesions developed re-stenosis during follow-up. Re-stenosis rates were 18%, 21% and 26% at 6, 9 and 12 months, respectively. Predictors of re-stenosis included non-white race, ischemic etiology, intervention precipitated by symptoms and severe stenosis (>/=90% stenosis) of the target lesion.
  
  
  CONCLUSIONS
  Use of DES has a favorable outcome when used in heart transplant patients for the treatment of CAV. An aggressive strategy for the treatment of CAV using DES may provide good long-term outcome compared with other available therapies.
authors.affiliation: Division of Cardiovascular Disease, University of Alabama at Birmingham, Alabama 35294, USA. raed.aqel@med.va.gov
authors.forename: Raed A
authors.initials: RA
authors.lastname: Aqel
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Wells
authors.forename: Fadi G
authors.initials: FG
authors.lastname: Hage
authors.forename: Jose
authors.initials: J
authors.lastname: Tallaj
authors.forename: Raymond
authors.initials: R
authors.lastname: Benza
authors.forename: Salpy
authors.initials: S
authors.lastname: Pamboukian
authors.forename: Barry
authors.initials: B
authors.lastname: Rayburn
authors.forename: David
authors.initials: D
authors.lastname: McGiffin
authors.forename: James
authors.initials: J
authors.lastname: Kirklin
authors.forename: Robert
authors.initials: R
authors.lastname: Bourge
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006083:Graft Occlusion, Vascular / Q000209:etiology*; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D014184:Transplantation, Homologous; D016896:Treatment Outcome