Elevated Levels of Plasma C-Reactive Protein Are Associated With Decreased Graft Survival in Cardiac Transplant Recipients

Eisenberg, Marc S.; Chen, Hong Jun; Warshofsky, Mark; Sciacca, Robert R.; Wasserman, Hal S.; Schwartz, Allan; Rabbani, LeRoy E.

doi:10.1161/01.cir.102.17.2100

Cited by 85 publications

(53 citation statements)

References 60 publications

(39 reference statements)

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“…The elevation of CRP levels is considered to be a strong predictor of development of CAV and its elevation is associated with subsequent allograft failure in cardiac transplant recipients [4,5]. Likewise, a higher BNP level in patients long after heart transplantation is associated with CAV and allograft dysfunction and represents an independent predictive risk of cardiovascular death [6].…”

Section: Discussionmentioning

confidence: 99%

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Cardiac allograft vasculopathy

Bella

Minutoli

Coglitore

et al. 2010

Herz

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Cardiac allograft vasculopathy (CAV) is an accelerated form of coronary artery disease affecting both intramyocardial and epicardial coronary arteries and is observed in patients during long-term survival after cardiac transplantation. We report a case of CAV complicated with silent transmural myocardial infarction and massive left ventricular thrombus formation associated with silent pericarditis and with ischemic and non-ischemic scar tissue, as detected by cardiac magnetic resonance imaging (CMRI). The authors suggest CMRI as an additional technique along with echocardiography during follow-up of heart transplant recipients. CMRI may contribute to the early identification of areas of myocardial wall abnormalities suggestive of CAV, thus guiding diagnosis and prompt percutaneous treatment.

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Section: Discussionmentioning

confidence: 99%

“…Auflage, 190 S., 25 Abb., 5 Zusammenfassend bietet das vorliegende Buch einen sehr guten, umfassenden Überblick über die Tätigkeit als Honorararzt und ist jedem zu empfehlen, der sich mit dem Gedanken trägt, in dieser zunehmend attraktiven Beschäftigungs-form als Arzt tätig zu werden.…”

Section: Honorararzt -Flexibilität Und Freiberuflichkeitunclassified

Cardiac allograft vasculopathy

Bella

Minutoli

Coglitore

et al. 2010

Herz

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“…35 Elevated levels of C-reactive protein, a sensitive marker of systemic inflammation, have been associated with the development of CAV 36 -38 and predict graft dysfunction. 37,39 Elevated plasma levels of BNP, which reflect wall stress and structural remodeling of the graft, have also been correlated with the development of CAV in the late post-HT phase. 40 The hypothesis of this study was that vWF, as a marker of endothelial dysfunction/activity, would be elevated in patients who develop the disease.…”

Section: Discussionmentioning

confidence: 99%

Follow-up Study on the Utility of von Willebrand Factor Levels in the Diagnosis of Cardiac Allograft Vasculopathy

Martínez‐Dolz

Almenar

Regañón

et al. 2008

The Journal of Heart and Lung Transplantation

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“…The ability of CRP to induce TF expression 10 may explain the recently reported association between elevated levels of CRP and decreased graft survival in cardiac transplantation patients. 6 The association between elevated TF expression and CAV could lead to several potential therapeutic strategies to either retard or prevent the progression of CAV. We have shown that TF activity is increased on the smooth muscle and endothelial cell surface in response to oxidant stress, such as that initiated by hydrogen peroxide and lipid hydroperoxides.…”

Section: Yen Et Al Tissue Factor and Cardiac Allograft Vasculopathymentioning

confidence: 99%

“…6,7 Our group and others have demonstrated in vascular cells that tissue factor (TF), a 47-kd cell membrane-bound glycoprotein that initiates the extrinsic coagulation cascade leading to thrombin formation by binding factor VII, is upregulated in response to oxLDL. 8,9 CRP has also been shown to induce TF expression in monocytes.…”

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Increased Tissue Factor Expression Predicts Development of Cardiac Allograft Vasculopathy

et al. 2002

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Background-Cardiac allograft vasculopathy (CAV) limits the long-term success of cardiac transplantation. The incidence of CAV is increased in patients with elevated plasma levels of oxidized lipids or fibrin deposition within right heart biopsy (RHB) specimens. The present study investigated whether tissue factor (TF), the expression of which is regulated by oxidized lipids, is upregulated in patients with CAV. Methods and Results-A TF score was developed to quantify TF expression in RHB specimens from 63 consecutive patients undergoing routine annual posttransplantation RHB and coronary angiography. In patients Ͼ2 years (3.0Ϯ0.8 years) posttransplantation (nϭ35), a high TF score was observed with greater frequency (75% versus 26%, PϽ0.004) in patients with CAV than those without CAV. In patients Ͻ2 years (0.87Ϯ0.48 years) posttransplantation (nϭ28) without evidence of CAV, the TF score was determined and patients were followed up prospectively. A high TF score had a positive predictive value of 78.6% for the development of CAV, and a low TF score had a negative predictive value of 100%. Conclusions-These data demonstrate that early TF expression predicts subsequent development of CAV. Increased TF expression could link the elevated levels of oxidized LDL and fibrin deposition known to precede CAV. These findings suggest that TF may play a role in the pathophysiology of CAV and could offer a potential prognostic tool and a novel target for the prevention of CAV, possibly with antioxidants or inhibitors of the TF pathway.

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Elevated Levels of Plasma C-Reactive Protein Are Associated With Decreased Graft Survival in Cardiac Transplant Recipients

Abstract: These findings suggest that elevated plasma levels of CRP are associated with subsequent allograft failure in cardiac transplant recipients.

Cited by 85 publications

References 60 publications

Cardiac allograft vasculopathy

Cardiac allograft vasculopathy

Follow-up Study on the Utility of von Willebrand Factor Levels in the Diagnosis of Cardiac Allograft Vasculopathy

Increased Tissue Factor Expression Predicts Development of Cardiac Allograft Vasculopathy

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