التفاصيل البيبلوغرافية
| العنوان: |
Outcomes and Characteristics of Heart Transplant Recipients Requiring Oral Vasopressor Agents. |
| المؤلفون: |
Elkholey, K.1 (AUTHOR), Schlendorf, K.1 (AUTHOR), Biaggioni, I.1 (AUTHOR), Amancherla, K.1 (AUTHOR), Brinkley, D.1 (AUTHOR), Lindenfeld, J.1 (AUTHOR), Menachem, J.1 (AUTHOR), Ooi, H.1 (AUTHOR), Pedrotty, D.1 (AUTHOR), Punnoose, L.1 (AUTHOR), Rali, A.1 (AUTHOR), Sacks, S.B.1 (AUTHOR), Wigger, M.1 (AUTHOR), Zalawadiya, S.1 (AUTHOR), Siddiqi, H.1 (AUTHOR) |
| المصدر: |
Journal of Heart & Lung Transplantation. 2023 Supplement, Vol. 42, pS329-S329. 1p. |
| مصطلحات موضوعية: |
*HEART transplant recipients, *VASOCONSTRICTORS, *HEART transplantation, *CHRONIC kidney failure, *ATRIAL fibrillation |
| الشركة/الكيان: |
VANDERBILT University. Medical Center |
| مستخلص: |
Heart transplantation (HTx) results in denervation of the donor heart and potential impairment of autonomic reflexes in the recipient. Persistent symptomatic vasoplegia in HTx recipients has been reported, and may require treatment with the oral vasopressors (OVP) midodrine and/or droxidopa. The clinical significance of the need for OVP is unclear. We sought to identify predictors of and outcomes related to post-HTx OVP use. This retrospective analysis included all adults undergoing first-time single organ HTx from March 2000 to June 2022 at Vanderbilt University Medical Center. OVP use was determined by prescription of midodrine and/or droxidopa after discharge from index HTx hospitalization. Logistic regression modeling was used to identify predictors of and outcomes associated with use of OVP. The primary outcome was a composite of all-cause hospitalization and all-cause mortality at 1 and 5 years post-HTx. A total of 563 patients (mean age 56.1 ± 12.9 years; 70.9% males) were included in the analysis, of whom 60 required OVP after HTx (mean age 56.8 ± 13.7 years; 76.8% males). OVP patients had a higher pre-HTx burden of atrial fibrillation (AF) and chronic kidney disease (CKD), and were more likely to be sex mismatched with the donor than those not requiring OVP. After adjusting for sex mismatch, recipient characteristics (gender, AF, CKD, stroke, amyloid, diabetes, listing status at transplant), donor diabetes and donation type, post-HTx use of OVP was associated with significantly higher primary outcome at 1 year (HR 1.56, 95% CI 1.03-2.38, p=0.03) and 5 years (HR 1.61, 95% CI 1.08-2.41, p=0.01). Pre-HTx AF in the recipient was independently associated with OVP use after HTx (OR 2.95, 95% CI 1.36-6.44, p=0.006). Use of OVP after HTx was associated with a significantly higher 1- and 5-year composite of hospitalization and mortality. Recipient pre-HTx AF was independently associated with use of OVP post-HTx. [ABSTRACT FROM AUTHOR] |
| قاعدة البيانات: |
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