title: Clinical and angiographic outcomes with everolimus eluting stents for the treatment of cardiac allograft vasculopathy.
abstract: OBJECTIVE
  This study aimed to examine clinical efficacy, safety, and intermediate clinical outcomes with everolimus-eluting stents (EESs) in patients with transplant coronary artery disease (TCAD).
  
  
  BACKGROUND
  TCAD is a major cause of mortality in patients following orthotopic heart transplantation (OHT). Systemic everolimus in OHT patients has been shown to reduce TCAD. The safety and efficacy of an EES, the Xience V, have not been evaluated in this population.
  
  
  METHODS
  Patients post-OHT with hemodynamically significant CAD who underwent percutaneous coronary intervention (PCI) with EES were included. Participants were maintained on dual antiplatelet therapy for 1-year post-PCI. We examined procedural success, in-hospital and 1-year mortality, stent thrombosis, angiographic restenosis, and myocardial infarction rates. All patients had follow-up angiography 1-year after PCI. Target vessel revascularization (TVR), target lesion revascularization (TLR), in-segment restenosis, target vessel failure (TVF), and lumen late loss were noted.
  
  
  RESULTS
  PCI was performed in 34 de novo lesions in 21 patients, and 40 EES were placed. Procedural success rate was 100%. Average stent was 16.5 ± 5.1 mm long and 3.0 ± 0.6 mm in diameter. All patients had angiographic follow-up (409 ± 201 days). There was no stent thrombosis, deaths, or myocardial infarctions during follow-up. Two patients had focal in-stent restenosis. TLR rate was 5.9% (2/34), and TVR rate was 11.1% (3/27). Quantitative coronary angiography (QCA) showed stenosis diameter to be 19.98 ± 17.57%.
  
  
  CONCLUSIONS
  Use of an EES is associated with a low incidence of TVR and TLR in patients with TCAD. Further studies are needed to determine whether PCI with EES changes long-term outcomes.
authors.affiliation: Cedars-Sinai Medical Center, Heart Institute, Los Angeles, California.
authors.forename: Babak
authors.initials: B
authors.lastname: Azarbal
authors.forename: Boris
authors.initials: B
authors.lastname: Arbit
authors.forename: Radhakrishnan
authors.initials: R
authors.lastname: Ramaraj
authors.forename: Michelle
authors.initials: M
authors.lastname: Kittleson
authors.forename: Amelia
authors.initials: A
authors.lastname: Young
authors.forename: Lawrence
authors.initials: L
authors.lastname: Czer
authors.forename: Matthew
authors.initials: M
authors.lastname: Rafiei
authors.forename: Jesse
authors.initials: J
authors.lastname: Currier
authors.forename: Raj
authors.initials: R
authors.lastname: Makkar
authors.forename: Jon
authors.initials: J
authors.lastname: Kobashigawa
mesh_terms: D064591:Allografts; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D016027:Heart Transplantation; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications; D012189:Retrospective Studies; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus