Navigation Links
Survival rates lower for heart transplant patients whose arteries reclose after stenting
Date:6/18/2012

Heart transplant patients are notorious for developing an aggressive form of coronary artery disease that can often result in heart failure, death or the need for repeat transplantation. The condition can also have a negative impact on future cardiac procedures, such as stenting.

Transplant patients are among those at highest risk of adverse outcomes when receiving a stent to address a blockage in an artery. Compared with the general public, these patients have a much higher rate of restenosis, a side effect of stenting in which the artery becomes re-blocked because of an exaggerated scarring process at the stenting site.

New research by UCLA researchers and colleagues has found that heart transplant patients who develop restenosis after receiving a stent have poor long-term survival. Their study, one of the largest and longest follow-up studies of this patient population, appeared in the June 15 edition of the American Journal of Cardiology.

"The findings point to the need for improvements in prevention and treatment of transplant coronary artery disease that may help reduce restenosis for patients who require later cardiac procedures like stenting," said Dr. Michael Lee, an assistant professor of cardiology at the David Geffen School of Medicine at UCLA.

A stenting procedure begins with an angioplasty, in which a catheter is placed in an artery of the groin and a tiny wire is snaked up through the artery to the blocked area of the heart. The clogged artery is cleaned out, and then a stent a tiny wire-mesh tube is passed up through the artery and deployed to keep the artery open, allowing blood to flow freely through the heart again.

Currently, there are no guidelines or treatment recommendations for in-stent restenosis for transplant coronary artery disease, Lee said. He suggests that a scoring system to help pinpoint risks might help identify good candidates for stenting and other catheter-based procedures.

For the study, Lee and his team followed 105 heart transplant patients who underwent a stent procedure at UCLA Medical Center between 1995 and 2009. Patients received either a bare metal stent or, in the later years of the study, a newer medication-coated stent that can help impede restenosis development.

The team found that patients at a seven-year follow-up who had not developed in-stent restenosis were further from an end-point of death, heart attack or repeat transplantation (63.2 percent) than patients who had developed restenosis (27.9 percent). This was primarily due to a lower survival rate in patients who developed restenosis (38.5 percent) compared to patients who did not (84.2 percent).

According to Lee, typically up to 50 percent of heart transplant patients who receive a medication-coated stent develop restenosis, compared with only 5 to 10 percent of the general population.

Researchers note that the exact mechanism that heightens the risk of death and heart attack and increases the need for additional transplant in patients with transplant coronary artery disease who develop in-stent restenosis is not known.

Lee added that organ rejection may contribute to transplant coronary disease and play a role in the increased risk of mortality. The development of blood clots in the arteries, known as intracoronary thrombus, may also contribute to mortality.

"We may find that development of restenosis in heart transplant patients may be a marker of a more aggressive inflammatory response and part of transplant rejection," Lee said.

Further studies will help better understand the role of other factors in developing transplant coronary artery disease and in-stent restenosis.


'/>"/>

Contact: Rachel Champeau
rchampeau@mednet.ucla.edu
310-794-2270
University of California - Los Angeles Health Sciences
Source:Eurekalert

Related medicine news :

1. Scientists discover mechanism that promotes lung cancer growth and survival
2. Haematopoietic stem cell transplantation increases survival in systemic sclerosis patients
3. Pre-op Treatments Boost Survival for Esophageal Cancer Patients: Study
4. ASCO: Younger colon cancer patients have worse prognosis at diagnosis, yet better survival
5. Fitness May Boost Survival for Women With Breast Cancer
6. Chemotherapys effect on overall survival seems to increase based on tumor size
7. Cancer vaccine combination therapy shows survival benefit in breast cancer
8. Living longer - variability in infection-fighting genes can be a boon for male survival
9. Exercise May Boost Survival in Breast, Colon Cancer Patients
10. UC Irvine study finds racial, economic disparities in ovarian cancer care, survival
11. Living Near Major Roads May Shorten Heart Attack Survival
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/28/2017)... ... 2017 , ... Via Oncology, the leading provider of oncology ... public-facing tool for analyzing the costs of various drug regimens in cancer care. ... patients, providers, insurers and pharmaceutical companies about the estimated costs of treatment options. ...
(Date:3/28/2017)... ... March 28, 2017 , ... The Radiology Business Management Association (RBMA) ... as its new executive director. Mr. Still was selected through a careful months-long search ... as he is known to our members, has been a part of building the ...
(Date:3/28/2017)... ... March 28, 2017 , ... With less than 10,000 dermatologists ... to quality care can be limited while the desire to conquer breakouts and eliminate ... acne care for every customer online, today released its inaugural survey on the State ...
(Date:3/28/2017)... ... March 28, 2017 , ... A minimally invasive ... “perfect smile.” The National Association of Dental Laboratories (NADL) is informing dentists about ... aware of when utilizing dental laboratories and technicians that create these veneers. ...
(Date:3/28/2017)... ... March 28, 2017 , ... With expansion and efficiency in mind, ... March. , The seed processing plant opened in Marshallville in 2006, and a bagging ... office allows opportunity for transition of Patten Seed operations to the Middle Georgia location ...
Breaking Medicine News(10 mins):
(Date:3/28/2017)... New York , March 28, 2017 ... a largely consolidated vendor landscape, with the top three ... Agilent Technologies accounting for a significant 49% of the ... a recent report. The vendor landscape is intensely competitive ... share in the overall market. These factors have restricted ...
(Date:3/28/2017)... and TEL AVIV, Israel , March 28, ... in Israel . This new business entity, Emosis ... mostly dedicated to research and development of novel assays complementing the ... also, when relevant, locally support commercialization and sales development of Emosis ... This strategic ...
(Date:3/28/2017)... ROCKVILLE, Md. , March 28, 2017 /PRNewswire/ ... dedicated to innovative therapeutics addressing cancer and other ... at the American Association for Cancer Research annual ... April 3 is entitled "Evaluation of ENMD-2076 ... and the second poster to be presented ...
Breaking Medicine Technology: