This review highlights early pathologic and circulating markers of allograft arteriopathy to better understand and potentially mitigate transplant-associated coronary artery disease.
These markers may aid early risk stratification after cardiac transplant; leaves open whether targeting them alters CAD progression.
Transplant-associated coronary artery disease (CAD) is the principal limiting factor for the long-term survival of heart transplant patients. This review discusses early risk factors for the subsequent development of transplant-associated CAD. Early risk factors associated with a prothrombogenic microvasculature, such as deposition of microvascular fibrin, depletion of vascular tissue plasminogen activator, presence of endothelial activation of the allograft arterial tree, and loss of vascular antithrombin, as well as changes in circulation (ie, detectable serum cardiac troponin I and elevated serum soluble intercellular adhesion molecule-1 levels) are presented and discussed. New therapies that could improve the status of the allograft microvasculature and may prevent or mitigate the development of transplant-associated CAD are considered.
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Labarrere et al. (2001) studied this question.
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