Conflict of interest: the authors of this manuscript have no conflicts of interest to disclose.
Factors associated with the development of cardiac allograft vasculopathy – a systematic review of observational studies
Article first published online: 13 DEC 2011
© 2011 John Wiley & Sons A/S
Volume 26, Issue 2, pages E111–E124, March/April 2012
How to Cite
Braga, J. R., Santos, I. S. O., McDonald, M., Shah, P. S. and Ross, H. J. (2012), Factors associated with the development of cardiac allograft vasculopathy – a systematic review of observational studies. Clinical Transplantation, 26: E111–E124. doi: 10.1111/j.1399-0012.2011.01565.x
- Issue published online: 16 APR 2012
- Article first published online: 13 DEC 2011
- Accepted for publication 8 September 2011
- cardiac allograft vasculopathy;
- heart transplantation;
- risk factors;
- systematic review
Braga JR, Santos ISO, McDonald M, Shah PS, Ross HJ. Factors associated with the development of cardiac allograft vasculopathy – a systematic review of observational studies. Clin Transplant 2011 DOI: 10.1111/j.1399-0012.2011.01565.x. © 2011 John Wiley & Sons A/S.
Abstract: Cardiac allograft vasculopathy (CAV) is a significant factor impacting outcomes after heart transplant. We performed a systematic review of risk factors for the development of CAV. A search of electronic databases was performed. The eligibility criteria included cohort and case–control studies with more than 50 adult patients submitted to a heart transplant. The outcome should be CAV diagnosed by angiography and/or intravascular ultrasound (IVUS). Two reviewers performed study selection, data abstraction, and quality assessment. Of 2514 citations, 66 articles were included – 46 had 200 participants or less; 61 were single-center; and 44 were retrospective cohorts. The most used definition of CAV using angiography was the detection of any degree of abnormality (21 studies of 58). In studies using IVUS, an intimal thickness ≥0.5 mm was the most used definition (five of eight studies). Quality assessment revealed an inadequate description of patient selection, attrition, and accounting of potential confounders. Donor age, recipient age, recipient gender, etiology of heart failure, ischemic time, human leukocyte antigen matching, cytomegalovirus, lipid profile, and rejection episodes were the most studied factors. Our review indicates that the current evidence is not consistent across different studies. The definite contribution of risk factors for the development of CAV is still to be determined.