title: Cardiac allograft vasculopathy compared by intravascular ultrasound sonography: everolimus to mycophenolate mofetil--one single-center experience.
abstract: Cardiac allograft vasculopathy (CAV) remains one of the leading causes of late graft failure and death. Cyclosporine microemulsion Neoral (CsA) had been used in heart transplantation (HTx) recipients. Meanwhile, Everolimus (EVL; Certican, Norvatis Pharmaceuticals; Basel, Switzerland) or mycophenolate mofetil (MMF) have been combined with CsA for maintenance treatment. We compared atherosclerosis in HTx patients showing CAV by intravascular ultrasound (IVUS) in two groups: the CE who received CsA, EVL, and steroid versus the CM group, who received CsA, MMF, and steroid.
  
  
  METHODS
  We explored IVUS parameters such as plaque thickness (PT), lumen circumference (LC), media adventitial circumference, lumen diameter (LD), and media adventitial diameter to characterize the atherosclerosis among CE versus CM groups.
  
  
  RESULTS
  In this study, both the CE and CM groups showed increased plaque thickening in the first year posttransplantation (P < .05). However, MMF significantly reduced LC and LD (P < .05) Upon multivariate linear regression analysis, the CE group seemed to show less effect on the maximal difference in PT between 2 and 12 months after adjusting for age at transplantation and gender (P < .05). There was no acute clinical adverse event of CAV reported in either both group during the follow-up. The atherosclerosis of CAV revealed by LC, LDmax, and LDmin was significantly less among patients treated with CE than CM.
  
  
  CONCLUSIONS
  These results suggested that everolimus-treated patients showed benefits compared with MMF-treated subjects as extrapolated from these IVUS data.
authors.affiliation: Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: N-K
authors.initials: NK
authors.lastname: Chou
authors.forename: C-F
authors.initials: CF
authors.lastname: Jan
authors.forename: N-H
authors.initials: NH
authors.lastname: Chi
authors.forename: C-M
authors.initials: CM
authors.lastname: Lee
authors.forename: I-H
authors.initials: IH
authors.lastname: Wu
authors.forename: S-C
authors.initials: SC
authors.lastname: Huang
authors.forename: Y-S
authors.initials: YS
authors.lastname: Chen
authors.forename: H-Y
authors.initials: HY
authors.lastname: Yu
authors.forename: C-I
authors.initials: CI
authors.lastname: Tsao
authors.forename: W-J
authors.initials: WJ
authors.lastname: Ko
authors.forename: S-H
authors.initials: SH
authors.lastname: Chu
authors.forename: S-S
authors.initials: SS
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000517:prevention & control*; D016572:Cyclosporine / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D000068338:Everolimus; D005260:Female; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D020123:Sirolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013256:Steroids / Q000627:therapeutic use; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D007166:Immunosuppressive Agents; D013256:Steroids; D016572:Cyclosporine; D000068338:Everolimus; D009173:Mycophenolic Acid; D020123:Sirolimus