Systemic immunosuppressive therapy inhibits in-stent restenosis in patients with renal allograft

Jae Hun Jung, Pil Ki Min, Jong Youn Kim, Sungha Park, Eui Young Choi, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Won Heum Shim, Seung Yun Cho

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Cyclosporine is used routinely for prophylaxis for renal allograft rejection. In experimental animal studies, cyclosporine had been shown to inhibit smooth muscle cell proliferation during the arterial response to injury. We investigated whether systemic immunosuppression may inhibit in-stent restenosis in renal transplant patients undergoing coronary stenting. Methods: From 1993 to 2003, 33 renal transplant patients with 45 coronary lesions and 37 dialysis patients with 52 lesions underwent coronary stenting using bare metal stents at our center. We followed all patients clinically for a mean period of 37 ± 31 months and 40 patients angiographically at 14 ± 15 months after coronary intervention. Cyclosporine was combined with corticosteroids in 32 patients and one patient received tacrolimus instead of cyclosporine. Results: The baseline clinical and angiographical characteristics were similar and the success rate of the procedure was 100% in both groups. In renal transplant group, the mean dose of cyclosporine was 192.5 ± 68 mg/day and the blood cyclosporine level at the time of procedure was 152.9 ± 51.5 ng/mL. The rate of in-stent restenosis was 7.1% in renal transplant group and 57.1% in dialysis group (P < 0.0001). The mean late loss was 0.47 ± 0.57 mm in renal transplant group when compared with 1.51 ± 1.09 mm in dialysis group (P = 0.004). The overall rate of major adverse cardiac events (MACEs) was 6.1% in renal transplant group and 35.1% in dialysis group (P < 0.0001). Conclusions: Renal transplant patients receiving combined immunosuppressive agents showed markedly low rates of in-stent restenosis and MACE after coronary revascularization with stent. We consider that this result may be related to the ability of combined immunosuppressive therapy to inhibit inflammatory reaction and vascular smooth muscle cell proliferation induced by coronary stenting.

Original languageEnglish
Pages (from-to)567-573
Number of pages7
JournalCatheterization and Cardiovascular Interventions
Volume68
Issue number4
DOIs
Publication statusPublished - 2006 Oct 1

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Immunosuppressive Agents
Stents
Allografts
Cyclosporine
Kidney
Transplants
Dialysis
Therapeutics
Smooth Muscle Myocytes
Cell Proliferation
Tacrolimus
Vascular Smooth Muscle
Immunosuppression
Adrenal Cortex Hormones
Metals
Wounds and Injuries

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

Cite this

Jung, Jae Hun ; Min, Pil Ki ; Kim, Jong Youn ; Park, Sungha ; Choi, Eui Young ; Ko, Young Guk ; Choi, Donghoon ; Jang, Yangsoo ; Shim, Won Heum ; Cho, Seung Yun. / Systemic immunosuppressive therapy inhibits in-stent restenosis in patients with renal allograft. In: Catheterization and Cardiovascular Interventions. 2006 ; Vol. 68, No. 4. pp. 567-573.
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title = "Systemic immunosuppressive therapy inhibits in-stent restenosis in patients with renal allograft",
abstract = "Background: Cyclosporine is used routinely for prophylaxis for renal allograft rejection. In experimental animal studies, cyclosporine had been shown to inhibit smooth muscle cell proliferation during the arterial response to injury. We investigated whether systemic immunosuppression may inhibit in-stent restenosis in renal transplant patients undergoing coronary stenting. Methods: From 1993 to 2003, 33 renal transplant patients with 45 coronary lesions and 37 dialysis patients with 52 lesions underwent coronary stenting using bare metal stents at our center. We followed all patients clinically for a mean period of 37 ± 31 months and 40 patients angiographically at 14 ± 15 months after coronary intervention. Cyclosporine was combined with corticosteroids in 32 patients and one patient received tacrolimus instead of cyclosporine. Results: The baseline clinical and angiographical characteristics were similar and the success rate of the procedure was 100{\%} in both groups. In renal transplant group, the mean dose of cyclosporine was 192.5 ± 68 mg/day and the blood cyclosporine level at the time of procedure was 152.9 ± 51.5 ng/mL. The rate of in-stent restenosis was 7.1{\%} in renal transplant group and 57.1{\%} in dialysis group (P < 0.0001). The mean late loss was 0.47 ± 0.57 mm in renal transplant group when compared with 1.51 ± 1.09 mm in dialysis group (P = 0.004). The overall rate of major adverse cardiac events (MACEs) was 6.1{\%} in renal transplant group and 35.1{\%} in dialysis group (P < 0.0001). Conclusions: Renal transplant patients receiving combined immunosuppressive agents showed markedly low rates of in-stent restenosis and MACE after coronary revascularization with stent. We consider that this result may be related to the ability of combined immunosuppressive therapy to inhibit inflammatory reaction and vascular smooth muscle cell proliferation induced by coronary stenting.",
author = "Jung, {Jae Hun} and Min, {Pil Ki} and Kim, {Jong Youn} and Sungha Park and Choi, {Eui Young} and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang and Shim, {Won Heum} and Cho, {Seung Yun}",
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Systemic immunosuppressive therapy inhibits in-stent restenosis in patients with renal allograft. / Jung, Jae Hun; Min, Pil Ki; Kim, Jong Youn; Park, Sungha; Choi, Eui Young; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Shim, Won Heum; Cho, Seung Yun.

In: Catheterization and Cardiovascular Interventions, Vol. 68, No. 4, 01.10.2006, p. 567-573.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Systemic immunosuppressive therapy inhibits in-stent restenosis in patients with renal allograft

AU - Jung, Jae Hun

AU - Min, Pil Ki

AU - Kim, Jong Youn

AU - Park, Sungha

AU - Choi, Eui Young

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Shim, Won Heum

AU - Cho, Seung Yun

PY - 2006/10/1

Y1 - 2006/10/1

N2 - Background: Cyclosporine is used routinely for prophylaxis for renal allograft rejection. In experimental animal studies, cyclosporine had been shown to inhibit smooth muscle cell proliferation during the arterial response to injury. We investigated whether systemic immunosuppression may inhibit in-stent restenosis in renal transplant patients undergoing coronary stenting. Methods: From 1993 to 2003, 33 renal transplant patients with 45 coronary lesions and 37 dialysis patients with 52 lesions underwent coronary stenting using bare metal stents at our center. We followed all patients clinically for a mean period of 37 ± 31 months and 40 patients angiographically at 14 ± 15 months after coronary intervention. Cyclosporine was combined with corticosteroids in 32 patients and one patient received tacrolimus instead of cyclosporine. Results: The baseline clinical and angiographical characteristics were similar and the success rate of the procedure was 100% in both groups. In renal transplant group, the mean dose of cyclosporine was 192.5 ± 68 mg/day and the blood cyclosporine level at the time of procedure was 152.9 ± 51.5 ng/mL. The rate of in-stent restenosis was 7.1% in renal transplant group and 57.1% in dialysis group (P < 0.0001). The mean late loss was 0.47 ± 0.57 mm in renal transplant group when compared with 1.51 ± 1.09 mm in dialysis group (P = 0.004). The overall rate of major adverse cardiac events (MACEs) was 6.1% in renal transplant group and 35.1% in dialysis group (P < 0.0001). Conclusions: Renal transplant patients receiving combined immunosuppressive agents showed markedly low rates of in-stent restenosis and MACE after coronary revascularization with stent. We consider that this result may be related to the ability of combined immunosuppressive therapy to inhibit inflammatory reaction and vascular smooth muscle cell proliferation induced by coronary stenting.

AB - Background: Cyclosporine is used routinely for prophylaxis for renal allograft rejection. In experimental animal studies, cyclosporine had been shown to inhibit smooth muscle cell proliferation during the arterial response to injury. We investigated whether systemic immunosuppression may inhibit in-stent restenosis in renal transplant patients undergoing coronary stenting. Methods: From 1993 to 2003, 33 renal transplant patients with 45 coronary lesions and 37 dialysis patients with 52 lesions underwent coronary stenting using bare metal stents at our center. We followed all patients clinically for a mean period of 37 ± 31 months and 40 patients angiographically at 14 ± 15 months after coronary intervention. Cyclosporine was combined with corticosteroids in 32 patients and one patient received tacrolimus instead of cyclosporine. Results: The baseline clinical and angiographical characteristics were similar and the success rate of the procedure was 100% in both groups. In renal transplant group, the mean dose of cyclosporine was 192.5 ± 68 mg/day and the blood cyclosporine level at the time of procedure was 152.9 ± 51.5 ng/mL. The rate of in-stent restenosis was 7.1% in renal transplant group and 57.1% in dialysis group (P < 0.0001). The mean late loss was 0.47 ± 0.57 mm in renal transplant group when compared with 1.51 ± 1.09 mm in dialysis group (P = 0.004). The overall rate of major adverse cardiac events (MACEs) was 6.1% in renal transplant group and 35.1% in dialysis group (P < 0.0001). Conclusions: Renal transplant patients receiving combined immunosuppressive agents showed markedly low rates of in-stent restenosis and MACE after coronary revascularization with stent. We consider that this result may be related to the ability of combined immunosuppressive therapy to inhibit inflammatory reaction and vascular smooth muscle cell proliferation induced by coronary stenting.

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