The impact of Angiotensin II Type 1 Receptor antibodies on morbidity and mortality in Heart Mate II supported recipients
Language English Country Czech Republic Media print-electronic
Document type Journal Article, Observational Study
PubMed
27132810
DOI
10.5507/bp.2016.025
Knihovny.cz E-resources
- Keywords
- Angiotensin II Type 1 Receptor, Heart Mate II, LVAD, heart transplantation,
- MeSH
- Adult MeSH
- HLA Antigens immunology MeSH
- Prosthesis-Related Infections etiology mortality MeSH
- Middle Aged MeSH
- Humans MeSH
- Nervous System Diseases etiology mortality MeSH
- Heart-Assist Devices adverse effects MeSH
- Postoperative Hemorrhage etiology MeSH
- Antibodies metabolism MeSH
- Receptor, Angiotensin, Type 1 immunology MeSH
- Graft Rejection immunology MeSH
- Prosthesis Failure MeSH
- Heart Failure immunology mortality therapy MeSH
- Heart Transplantation mortality MeSH
- Transplantation Immunology immunology MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Observational Study MeSH
- Names of Substances
- HLA Antigens MeSH
- Antibodies MeSH
- Receptor, Angiotensin, Type 1 MeSH
AIMS: One of the proposed limitations of left ventricular assist device (LVAD) therapy is high degree of sensitization. Apart from human leukocyte antigen (HLA), antibodies against Angiotensin II Type 1 Receptor (AT1R) have been associated with adverse outcomes. The purpose of this study was to compare complications and survival of anti - AT1R positive versus negative Heart Mate II (HMII) recipients. METHODS: Altogether 96 patients received HMII at our institution between 2008 and 2012. These were stratified into three groups: antibody positive before implantation (AT1R+), antibody conversion during support (AT1R-/+) and patients who remained antibody negative (AT1R-). Survival, major on-device adverse events and post-transplant rejections were assessed with Kaplan-Meier and log-rank tests. RESULTS: Two year on-device and overall survival was 78 ± 12% and 75 ± 10% in AT1R-, 60 ± 23% and 60 ± 15% in AT1R+ and 92 ± 6% and 87 ± 5% in AT1R-/+ group (P = 0.409, P = 0.185). Freedom from major adverse event at two years for AT1R-, AT1R+ and AT1R-/+ was 49 ± 14%, 53 ± 16% and 41 ± 11% (P = 0.875). Freedom from rejection was 63 ± 17% in patients who were both anti-AT1R and HLA negative and 65 ± 13% in those who were antibody positive (P = 0.788). CONCLUSION: Patients who were anti-AT1R antibody positive had similar on-device survival and rate of complications in comparison to those who were antibody negative. In transplanted patients, there were no differences in the overall survival and rejection between the groups.
Department of Cardiac Surgery Institute for Clinical and Experimental Medicine Prague Czech Republic
Department of Cardiology Institute for Clinical and Experimental Medicine Prague Czech Republic
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