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Intravascular Ultrasound Evidence of Angiographically Silent Progression in Coronary Atherosclerosis Predicts Long-Term Morbidity and Mortality After Cardiac Transplantation

E. Murat Tuzcu, MD, FACC^_*,_*, Samir R. Kapadia, MD, FACC^_*, Ravish Sachar, MD^_*, Khaled M. Ziada, MD, Timothy D. Crowe, BS^_*, Jingyuan Feng, MS, William A. Magyar, BS^_*, Robert E. Hobbs, MD, FACC^_*, Randall C. Starling, MD, FACC^_*, James B. Young, MD, FACC^_*, Patrick McCarthy, MD, FACC and Steven E. Nissen, MD, FACC^_*

^_* Department of Cardiovascular Medicine, Cleveland Clinic Foundation, Cleveland, Ohio
Gill Heart Institute, University of Kentucky, Lexington, Kentucky
Department of Biostatistics and Epidemiology, Cleveland Clinic Foundation, Cleveland, Ohio
Division of Cardiothoracic Surgery, Northwestern University, School of Medicine, Chicago, Illinois.

View larger version (70K): [in a new window]   Figure 1 There is a >0.5 mm difference between the intimal thickness observed at baseline. One-year intravascular ultrasound images which demonstrate rapidly progressive transplant vasculopathy.

View larger version (17K): [in a new window]   Figure 2 Distribution of patients according intravascular ultrasound findings.

View larger version (23K): [in a new window]   Figure 3 Distribution of events in patients with and without rapid progression of transplant vasculopathy. MI = myocardial infarction.

View larger version (13K): [in a new window]   Figure 4 Kaplan-Meier all-cause mortality (left) and death and myocardial infarction (MI) (right) rates of patients with and without rapidly progressive transplant vasculopathy. Thick lines = without rapid progression; thin lines = with rapid progression.