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Updated: Jul 4, 2025
A Pre-Clinical Porcine Model of Orthotopic Heart Transplantation
Published on: April 27, 2019
Ten-year outcomes post percutaneous coronary intervention in cardiac transplant recipients
Vinayak Nagaraja1, Bradley R Lewis2, Mandeep Singh1
1Department of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, MN, USA.
Insights
This study reports ten-year outcomes for percutaneous coronary intervention (PCI) in cardiac transplant recipients, revealing a significant 65.70% mortality rate and a median survival of 7.20 years, highlighting the long-term risks associated with this procedure.
Area of Science:
- Cardiology
- Transplant Surgery
- Interventional Cardiology
Background:
- Cardiac allograft vasculopathy (CAV) is a primary cause of late mortality in heart transplant recipients.
- Limited long-term data exists for percutaneous coronary intervention (PCI) outcomes in this patient population.
- This study addresses the need for extended follow-up data on PCI in cardiac transplant recipients.
Purpose of the Study:
- To report the ten-year follow-up outcomes of cardiac transplant recipients who underwent percutaneous coronary intervention (PCI).
- To evaluate the long-term survival and complications associated with PCI in this specific patient group.
Main Methods:
- Retrospective observational study of cardiac transplant recipients undergoing PCI at Mayo Clinic.
- Data analysis included descriptive statistics for continuous and discrete variables.
- Patient demographics, antirejection therapies, procedural details, and clinical outcomes were reviewed.
Main Results:
- Thirty-eight cardiac transplant recipients underwent PCI between 1995 and 2023.
- The median age was 61 years, with 65.80% males; 47.40% presented with acute coronary syndrome.
- Ten-year mortality was 65.70%, with a median survival of 7.20 years; 5.20% in-hospital mortality.
- Two patients required re-transplantation due to severe CAV.
Conclusions:
- This is the first report detailing ten-year outcomes of PCI in cardiac transplant patients.
- The study highlights a substantial 65.70% ten-year mortality rate and a median survival of 7.20 years.
- These findings underscore the significant long-term risks and challenges in managing CAV post-transplant with PCI.
Background:
Cardiac allograft vasculopathy (CAV) is one of the major late causes of mortality in cardiac transplant recipients beyond the first year. Given the lack of longer term data for PCI in cardiac transplant recipients, we report ten year follow up of such cardiac transplant recipients who underwent PCI at Mayo Clinic.
Methods:
A retrospective observational study was conducted that included cardiac transplant recipients who underwent PCI at the Mayo Clinic. Continuous variables were presented as mean (SD) or median (IQR) and discrete variables were presented as frequency (percentage).
Results:
Thirty-eight consecutive cardiac transplant recipients underwent PCI from January 1, 1995, to June 30, 2023, at the Mayo Clinic. The median age of the cohort was 61.00 years (IQR:51.00-70.00) comprised predominantly of men (65.80%), and 47.40% of the cohort presented with an acute coronary syndrome. The antirejection therapy prior to the PCI included steroids (47.30%), cyclosporine (26.30%), tacrolimus (15.80%), mycophenolate (42.10%), azathioprine (13.10%), & sirolimus (31.57%). Intravascular ultrasound during PCI was utilized in 10.50% of the cases. The median time duration between heart transplant and PCI was 9.00 years (IQR:6.00-13.00 years). Two individuals needed repeat heart transplant for severe CAV. In hospital mortality was 5.20% and the long-term median survival was 7.20 years with a 10-year mortality rate of 65.70%.
Conclusions:
This is the first publication reporting ten-year outcomes for PCI in cardiac transplant patients. The salient features for our cohort were a 65.70% mortality rate at 10 years and a median survival of 7.20 years.
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