Re-stenosis After Drug-eluting Stents in Cardiac Allograft Vasculopathy

Raed A. Aqel, Bryan J. Wells, Fadi G. Hage, Jose Tallaj, Raymond Benza, Salpy Pamboukian, Barry Rayburn, David McGiffin, James Kirklin, Robert Bourge

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18 Citations (Scopus)

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 ≥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.

Original languageEnglish
Pages (from-to)610-615
Number of pages6
JournalThe Journal of Heart and Lung Transplantation
Volume27
Issue number6
DOIs
Publication statusPublished - 1 Jun 2008
Externally publishedYes

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