Heart Transplantation Clinical Trial
Official title:
Multicenter International Observational Study to Identify Trajectories of Cardiac Allograft Vasculopathy After Heart Transplantation and Their Specific Determinants
This project aims: i) to identify Cardiac Allograft Vasculopathy (CAV) trajectories after heat transplantation using latent class mixed modeling, ii) to characterize the global and specific determinants of different trajectories and iii) to provide an easily accessible tool to project individual probability of CAV trajectory belonging.
Background:
Cardiac Allograft Vasculopathy (CAV) is the third cause of late mortality and the leading
cause of late allograft dysfunction. The field of heart transplantation currently lacks
longitudinal description of CAV profiles. Identifying relevant CAV trajectories, or evolution
profiles, and their respective determinants is an unmet clinical need. CAV trajectories
requires an additional level of understanding and characterization over the current paradigm.
Understanding the mechanisms and clinical factors involved in the development of CAV will be
useful to provide a more nuanced picture of disease progression, which may ultimately
contribute to risk stratification and ultimately guiding the care of HTx patients.
Main Outcome(s) and Measure(s):
- Identification of CAV trajectories after transplantation using an unsupervised latent
class mixed modeling. CAV angiograms were recorded per center protocol for all patients
after transplantation. CAV was graded according to the current ISHLT classification as
CAV 0 (not significant), 1 (mild), 2 (moderate) and 3 (severe).
- Determination of clinical, functional, structural, immunological factors associated with
the trajectories. In the derivation cohort, the associations between CAV trajectories
and clinical, histological, functional, and immunological parameters at the time of
transplantation, during the first year and at one-year post-transplant were assessed
using multinomial logistic regression.
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