After heart transplantation, adding everolimus (EVL) to standard immunosuppressive regimen mostly relies on converting from

 

Abstract

After heart transplantation, adding everolimus (EVL) to standard immunosuppressive regimen mostly relies on converting from calcineurin inhibitors (CNI) to EVL. The aim of this study was to describe the effects of combining low-dose EVL and CNI in maintenance immunosuppression regimen (quadritherapy) and compare it to standard tritherapy associating standard-dose CNI, MMF and corticosteroids. In 3-years registry cohort of heart transplanted patients, those who received quadritherapy were compared to those who received tritherapy. EVL was added after 3 months post-transplantation. Three analyses were performed to control for confounders: propensity-score matching, multivariable survival and inverse-probability-score weighting (IPSW) analyses. Among 213 patients who were included (75 with quadritherapy), propensity-score matching selected 64 unique pairs of patients with similar characteristics. In the matched cohort (n=128), quadritherapy was associated with fewer deaths (3 (4.7%) vs 17 (21.9%), p-value=0.007) and biopsy-proven acute rejections (15 (23.4%) vs 31 (48.4%), p-value=0.002). These results were confirmed in the overall cohort (n=213), after multivariable and IPSW analyses. Renal function and donor-specific HLA-antibodies remained similar in both groups. Low-dose combination quadritherapy was associated with fewer deaths and rejections, compared to standard immunosuppression tritherapy.

PMID: 32180354 [PubMed - as supplied by publisher]

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Cancer therapy cardiotoxicity detection: understanding the limitations of cardiac imaging.

Cancer therapy cardiotoxicity detection: understanding the limitations of cardiac imaging.

Heart. 2020 Mar 16;:

Authors: Palaskas N, Lopez-Mattei J

PMID: 32179588 [PubMed - as supplied by publisher]

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Hypertension and incident cardiovascular events following ibrutinib initiation.

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