title: Role of Vascular Disease in the Evolution of Heart Transplant Patients.
abstract: BACKGROUND
  The clinical profile of heart transplantation (HT) recipients has changed in recent years. Nowadays, we have to deal with a higher number of co-morbidities, including peripheral vascular disease (PVD). Previous studies suggest an increase in post-HT morbidity and mortality associated with PVD, especially when it is symptomatic. Our study aims were to analyze the prognostic implications of the presence of PVD before transplantation and to determine the factors associated with its development after it.
  
  
  METHODS
  HT patients (n = 217) who survived the first year after surgery were included in the study. Mean follow-up was 9 ± 5 years.
  
  
  RESULTS
  There were no statistically significant differences in mortality rates between patients with PVD (before or after HT) and those without. One third of patients with PVD required surgery in the post-HT monitoring, either revascularization or amputation. Furthermore, the prevalence of PVD was doubled. Dyslipidemia before HT (odds ratio [OR]: 2.9, 95% confidence interval [CI]: 1.3-6.4; P < .01) and older recipient age (OR: 1.05, 95% CI: 1.01-1.09; P < .05) were independently associated with development of PVD by means of multivariate analysis.
  
  
  CONCLUSIONS
  The presence of PVD must be evaluated individually in candidates for heart transplantation despite being a relative contraindication to it at the present time.
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain. Electronic address: lidiabore@gmail.com.
authors.forename: L
authors.initials: L
authors.lastname: Bos
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Mirabet
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Brossa
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: L
authors.initials: L
authors.lastname: Lopez
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sionis
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: H
authors.initials: H
authors.lastname: Capellades
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Cinca
authors.affiliation: Cardiology Department, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Roig
mesh_terms: D000328:Adult; D000367:Age Factors; D000671:Amputation, Surgical; D001014:Aortic Aneurysm / Q000453:epidemiology* / Q000601:surgery; D001018:Aortic Diseases / Q000453:epidemiology* / Q000601:surgery; D016893:Carotid Stenosis / Q000453:epidemiology* / Q000601:surgery; D002561:Cerebrovascular Disorders / Q000453:epidemiology* / Q000601:surgery; D015897:Comorbidity; D003251:Constriction, Pathologic / Q000453:epidemiology / Q000601:surgery; D018450:Disease Progression; D050171:Dyslipidemias / Q000453:epidemiology*; D005260:Female; D006333:Heart Failure / Q000453:epidemiology / Q000601:surgery*; D016027:Heart Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D016491:Peripheral Vascular Diseases / Q000453:epidemiology* / Q000601:surgery; D015995:Prevalence; D011379:Prognosis; D012078:Renal Artery Obstruction / Q000453:epidemiology* / Q000601:surgery; D012189:Retrospective Studies; D014652:Vascular Diseases