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Early aspirin initiation following heart transplantation is associated with reduced risk of allograft vasculopathy during long-term follow-up. Clin Transplant 2017 Dec;31(12)

Date

10/11/2017

Pubmed ID

28990263

DOI

10.1111/ctr.13133

Scopus ID

2-s2.0-85037658311 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

AIM: Cardiac allograft vasculopathy (CAV) is a major cause of morbidity and mortality after heart transplantation (HT). Enhanced platelet reactivity is a contributing factor. We aimed to investigate the association between early initiation of aspirin therapy post-HT and the 15-year risk of the development of CAV.

METHODS: We studied 206 patients who underwent HT between 1991 and 2016. Multivariate Cox proportional hazards regression modeling was employed to evaluate the association between early aspirin initiation and the long-term risk of CAV.

RESULTS: Ninety-seven patients (47%) received aspirin therapy. At 15 years of follow-up, the rate of CAV was lowered by sixfold in patients treated with aspirin compared with the non-treated patients: 7% vs 37% (log-rank P-value<.001). The corresponding rates of the combined end-point of CAV or death were also lower in patients treated with aspirin, compared with the non-treated patients: 42% vs 78% (log-rank P < .001). Consistently, multivariate analysis showed that early aspirin therapy was associated with a significant 84% (P < .001) reduction in CAV risk, and with a corresponding 68% (P < .0001) reduction in the risk of the combined end-point of CAV or death. We further validated these results using a propensity score-adjusted Cox model.

CONCLUSIONS: Early aspirin initiation is independently associated with a significant reduction in the risk of CAV.

Author List

Peled Y, Lavee J, Raichlin E, Katz M, Arad M, Kassif Y, Peled A, Asher E, Elian D, Har-Zahav Y, Shlomo N, Freimark D, Goldenberg I, Klempfner R

Author

Eugenia Raichlin MD Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Allografts
Anti-Inflammatory Agents, Non-Steroidal
Aspirin
Female
Follow-Up Studies
Graft Rejection
Graft Survival
Heart Transplantation
Humans
Male
Middle Aged
Postoperative Complications
Prognosis
Risk Factors
Survival Rate
Vascular Diseases