Kessler Iglesias, Cassia and Bloom, Jason E. and Xiao, Xiaoman and Moskovitch, Jeremy and Eckford, Hunter and Offen, Sophie and Kotlyar, Eugene and Keogh, Anne and Jabbour, Andrew and Bergin, Peter and Leet, Angeline and Hare, James L. and Taylor, Andrew J. and Hayward, Christopher S. and Jansz, Paul and Kaye, David M. and Macdonald, Peter S. and Muthiah, Kavitha (2025) Early Use of Aspirin for Coronary Allograft Prophylaxis in Heart Transplant Recipients. Transplantation, 109 (2). pp.346-351. ISSN 0041-1337
Full text not available from this repository.Abstract
Background.
Coronary allograft vasculopathy (CAV) remains a significant cause of morbidity and mortality after heart transplantation. The use of aspirin for CAV prophylaxis has recently garnered interest as a possible therapeutic adjunct in this setting.
Methods.
This 2-center retrospective cohort study included 372 patients who underwent heart transplantation between January 2009 and March 2018 and were stratified according to the commencement of aspirin during their index transplant admission. The primary outcome was the development of moderate or severe CAV (International Society for Heart and Lung Transplantation grade ≥2) at surveillance coronary angiography. Secondary endpoints included mortality at follow-up.
Results.
There were no differences in age, sex, and cause of heart failure. In the early aspirin group, the preponderant risk factors included use of ventricular assist devices, pretransplant smoking, and mild or moderate rejection. Multivariable analyses to assess for independent predictors of CAV development and mortality demonstrated that aspirin was associated with reduced mortality (adjusted hazard ratio = 0.19; 95% confidence interval, 0.08-0.47, P < 0.01) and a trend toward a protective effect against the development of moderate or severe CAV (adjusted hazard ratio = 0.24; 95% confidence interval, 0.54-1.19; P = 0.08).
Conclusions.
In this retrospective risk-adjusted 2-center cohort study, early aspirin administration was associated with reduced risk of death and a trend toward a protective effect against CAV development. These findings warrant validation in prospective randomized trials.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 05 May 2025 05:44 |
| Last Modified: | 05 May 2025 05:44 |
| URI: | https://eprints.victorchang.edu.au/id/eprint/1663 |
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