Lack of association between endomyocardial evidence of rejection in the first six months and the later development of transplant-related coronary artery disease

P G Stovin; L D Sharples; P M Schofield; N R Cary; P A Mullins; T A English; J Wallwork; S R Large

Lack of association between endomyocardial evidence of rejection in the first six months and the later development of transplant-related coronary artery disease

J Heart Lung Transplant. 1993 Jan-Feb;12(1 Pt 1):110-6.

Authors

P G Stovin¹, L D Sharples, P M Schofield, N R Cary, P A Mullins, T A English, J Wallwork, S R Large

Affiliation

¹ Papworth Hospital, Papworth Everard, Cambridge, U.K.

PMID: 8443188

Abstract

The development of transplant-related coronary artery disease (TCAD) is the major determinant of long-term heart transplant survival. To test the hypothesis that TCAD might be related to cellular myocardial rejection, the grades of rejection seen at all biopsies performed in the first 6 months after heart transplantation were analyzed in 108 patients who survived more than 6 months. The development of TCAD was assessed at routine follow-up coronary angiography in 101 patients and at necropsy in seven patients. This data was analyzed with Kaplan-Meier survival curves and Cox proportional hazard regression analysis. No significant association was found between either moderate rejection or any level of rejection and the later development of TCAD, nor did the absence of any rejection protect against its development.

MeSH terms

Biopsy, Needle*
Coronary Angiography
Coronary Disease / diagnostic imaging
Coronary Disease / etiology*
Endocardium / pathology*
Follow-Up Studies
Graft Rejection*
Heart Transplantation*
Humans
Myocardium / pathology*
Postoperative Complications
Regression Analysis
Survival Analysis
Time Factors