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Heart, Lung and Circulation

Chronic Rejection and Atherosclerosis in Post-Transplant Cardiovascular Mortality: Two Sides of the Same Coin

Published:November 27, 2021DOI:https://doi.org/10.1016/j.hlc.2021.09.016
      Cardiovascular disease (CVD) as defined by the American Heart Association includes ischaemic heart disease, stroke, heart failure and thromboembolism [
      • Go A.S.
      • Mozaffarian D.
      • Roger V.L.
      • Benjamin E.J.
      • Berry J.D.
      • Blaha M.J.
      • et al.
      Heart disease and stroke statistics - 2014 update: a report from the American Heart Association.
      ]. Solid organ transplantation is associated with an increased risk of CVD morbidity and mortality [
      • Smilowitz N.R.
      • Guo Y.
      • Rao S.
      • Gelb B.
      • Berger J.S.
      • Bangalore S.
      Perioperative cardiovascular outcomes of non-cardiac solid organ transplant surgery.
      ], a relationship which was first observed in the context of kidney transplantation by Foley in 1998 [
      • Foley R.N.
      • Parfrey P.S.
      • Sarnak M.J.
      Clinical epidemiology of cardiovascular disease in chronic renal disease.
      ]. This manifests clinically as an increased rate of major adverse cardiovascular events (MACE), defined as the composite of cardiac death, non-fatal myocardial infarction, non-fatal stroke, unstable angina and heart failure [
      • Aldrovandi A.
      • Maffei E.
      • Seitun S.
      • Martini C.
      • Berti E.
      • Grilli R.
      • et al.
      Major adverse cardiac events and the severity of coronary atherosclerosis assessed by computed tomography coronary angiography in an outpatient population with suspected or known coronary artery disease.
      ,
      • Choi B.G.
      • Rha S.W.
      • Yoon S.G.
      • Choi C.U.
      • Lee M.W.
      • Kim S.W.
      Association of major adverse cardiac events up to 5 years in patients with chest pain without significant coronary artery disease in the Korean population.
      ].

      Keywords

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