Cardiovascular risk profile after conversion from cyclosporine A to tacrolimus in stable renal transplant recipients

Détails

ID Serval
serval:BIB_0A7917B5EF98
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Cardiovascular risk profile after conversion from cyclosporine A to tacrolimus in stable renal transplant recipients
Périodique
Transplantation
Auteur⸱e⸱s
Baid-Agrawal  S., Delmonico  F. L., Tolkoff-Rubin  N. E., Farrell  M., Williams  W. W., Shih  V., Auchincloss  H., Cosimi  A. B., Pascual  M.
ISSN
0041-1337
Statut éditorial
Publié
Date de publication
04/2004
Peer-reviewed
Oui
Volume
77
Numéro
8
Pages
1199-202
Notes
Clinical Trial
Comparative Study
Journal Article
Research Support, Non-U.S. Gov't --- Old month value: Apr 27
Résumé
BACKGROUND: Cardiovascular disease is a major cause of morbidity and mortality in renal recipients. In addition to steroids, cyclosporine A (CsA) has been implicated in contributing to increased cardiovascular risk. Conversion from CsA to tacrolimus (TAC) has been shown to improve hyperlipidemia and hypertension, but little is known about the differential effects of CsA versus TAC on other cardiovascular risk factors. We investigated overall cardiovascular risk profile after conversion from CsA to TAC. METHODS: This was an open-label, single-arm prospective study; 22 adult renal recipients who were receiving CsA-based immunosuppression with serum total cholesterol greater than 200 mg/dL more than 1 year after transplantation were enrolled. CsA was replaced by TAC. Blood pressure, fasting lipid profile, homocysteine, fibrinogen, C-reactive protein, hemoglobin A1c, and creatinine were measured at baseline and at 3 and 6 months after conversion. RESULTS: There was a significant improvement in fibrinogen (366 +/- 81 - 316 +/- 65 mg/dL, P <0.001), total cholesterol (250 +/- 50 - 207 +/- 29 mg/dL, P <0.001), and low-density lipoprotein cholesterol (155 +/- 43 - 121 +/- 24 mg/dL, P <0.001) after conversion. No new onset or worsening of diabetes mellitus was observed after conversion. There were no significant differences in HDL cholesterol, triglycerides, homocysteine, C-reactive protein, hemoglobin A1c levels, serum creatinine, mean blood pressure, and mean number of antihypertensive medications required before and after conversion. CONCLUSIONS: Our results indicate that conversion to low-dose TAC may be preferable over CsA for chronic maintenance immunosuppression because it improves the overall cardiovascular risk profile without any apparent adverse effects.
Mots-clé
Adult Cardiovascular Diseases/blood/*etiology/prevention & control Cholesterol/blood Cholesterol, LDL/blood Cyclosporine/administration & dosage/*adverse effects Female Fibrinogen/metabolism Humans Immunosuppressive Agents/administration & dosage/*adverse effects Kidney Transplantation/*adverse effects/physiology Male Middle Aged Prospective Studies Risk Factors Tacrolimus/administration & dosage/*adverse effects
Pubmed
Web of science
Création de la notice
29/01/2008 13:53
Dernière modification de la notice
20/08/2019 12:32
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