Influence of traditional cardiovascular risk factors in the recipient on the development of cardiac allograft vasculopathy after heart transplantation.
BACKGROUND
Cardiac allograft vasculopathy (CAV) is the leading cause of death heart transplant (HT) recipients after the first year. We assessed the influence of cardiovascular risk factors (CVRFs) in HT recipients on the development of CAV after 1 year of follow-up.


METHODS
From 2001 to 2005, we studied 72 patients who received a HT and survived for at least 1 years. All patients underwent coronary arteriography and intravascular ultrasonography at 1 year after HT. Cardiac allograft vasculopathy was defined as intimal proliferation of 0.5 mm or more. The analyzed CVRFs were age, sex, body mass index, diabetes mellitus, hypertension, dyslipidemia, and smoking. We also considered the heart disease that was the reason for HT. The statistical tests used in the univariate analysis were the t and chi(2) tests. Logistic regression was performed with the variables obtained at univariate analysis.


RESULTS
Mean (SD) recipient age at HT was 51 (9) years. Eighty patients (90.5%) were men. Dyslipidemia was significantly associated with a greater incidence of CAV at 1 year (68.3% vs 41.9%; P = .03). Ischemia, as opposed to all other causes, was also significantly associated with CAV (69.4% vs 44.4%; P = .03). Older age, hypertension, smoking history, and high body mass index were associated with a higher incidence of CAV, albeit without statistical significance. At multivariate analysis, dyslipidemia was the most significant CVRF (P = .045) for the development of CAV.


CONCLUSIONS
Recipient dyslipidemia is a risk factor for the development of CAV in HT. The remaining traditional CVRFs are more weakly associated with CAV. After HT close monitoring of recipients with pretransplantation CVRFs is essential for early detection of CAV.
Sánchez Lázaro
I J
IJ
Heart Failure and Transplantation Unit, Department of Cardíology, La Fe University Hospital, Valencia, Spain. igsanla@comv.es
Almenar Bonet
L
L
Moro López
J
J
Sánchez Lacuesta
E
E
Martínez-Dolz
L
L
Agüero Ramón-Llín
J
J
Andrés Lalaguna
L
L
Cano Pérez
O
O
Ortiz Martínez
V
V
Buendía Fuentes
F
F
Salvador Sanz
A
A
D000704:Analysis of Variance; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D050171:Dyslipidemias / Q000150:complications; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000145:classification / Q000601:surgery; D016027:Heart Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D013997:Time Factors; D014184:Transplantation, Homologous / Q000473:pathology; D014652:Vascular Diseases / Q000453:epidemiology*