Transplant coronary artery disease: Incidence, progression and interventional revascularization

A Decade of Percutaneous Coronary Interventions in Cardiac Transplant Recipients: A Monocentric Study in 160 Patients

“…Only 2 studies from Time Period 2 were prospective, 12,20 and just 2 studies included a control group with conservative treatment. 15,20 Only 1 study was a multicenter study, 16 and only 1 study reported statistical modeling of risk stratification with respect to the time period of intervention. 10 The data given in most studies focused on and were largely confined to procedural data, including time to first PCI, number of lesions, BMSs, DESs, primary success, restenosis, and angiographic follow-up.…”

“…Treatment with statins is supported by evidence. 20,44,45 Long-term clopidogrel was significantly associated with deferred recurrence of stenosis and improved survival. The puzzling question is, why clopidogrel and 46 This may be due to enhanced endothelial activation in transplant vasculopathy compared with native coronary artery disease.…”

Successful Percutaneous Intervention to Acute Myocardial Infarction Presenting With Typical Chest Pain in Transplanted Heart

“…Multiple factors such as immunosupressive drugs, viral infections, donor age and presence of an acute rejection are believed to be involved in the pathophysiology of allograft vasculopathy. [1][2][3] The diagnosis of an acute coronary syndrome in cardiac transplant recipients is difficult as a consequence of autonomic denervation of the transplanted heart. 4 For this reason, acute coronary syndrome rarely presents as myocardial infarction in these patients.…”

“…Acute coronary syndrome is a rare presentation of allograft CAD. 1 Symptoms are usually atypical or absent as a result of cardiac denervation. We present a 27-year-old female patient with an acute myocardial infarction (AMI) who presented with typical chest pain and was successfully treated with percutaneous transluminal coronary angioplasty (PTCA).…”

Long-term outcome after bare-metal or drug-eluting stenting for allograft coronary artery disease

“…1 Small-sized observational studies have tended to show better outcome with revascularization compared with medical therapy in such patients. 2,3 Percutaneous coronary intervention (PCI) is considered the first-line revascularization therapy for CAV. PCI with bare-metal stenting (BMS) has been reported to be associated with high rates of acute success but high rates of restenosis in small-sized, heterogeneous, observational studies.…”