Abstract
<h3>Purpose</h3> Prevalence of donor-transmitted coronary artery disease (DTCAD) is variable among studies and its importance in long- and short-term outcomes after heart transplantation (HT) remains unclear. Our purpose was to establish the prevalence and characteristics of DTCAD in a multicentric cohort. <h3>Methods</h3> DONOR-CAD is a multicentric study developed to identify the prevalence and prognostic significance of DTACD. HT between 2008-2018 in 11 centers from Spain were analyzed. Inclusion criteria: > 18-yo and coronary angiogram (c-angio) performed within first 3months after HT or performed previously in the donor. Angiographically significant coronary artery disease (s-CAD) was defined as stenosis > or equal than 50% in epicardial coronary arteries. Non-angiographically-significant coronary artery disease (ns-CAD) was defined as stenosis < 50%. Coronary angiograms were evaluated by Quantitative Coronary Analysis (QCA) and for an interventional cardiologist. The study protocol was approved by the Committee for Ethics in Clinical Investigation of each participating hospital. <h3>Results</h3> From a global cohort of 2,005 patients, 1,901 were finally included. Basal c-angio was performed in 934 patients (49.1%). Most documented reason for not performing the basal c-angio was the mortality in the post-operative setting (31%). 28.3% of patients were transplanted with short-term mechanical circulatory support. Donors mean age was 44.58 yo (SD 12.49), 63.3% of donors were male and most common cause of death was the hemorrhagic stroke (49.5%). 20.3% of donors were smokers and 3.2% had diabetes type 2. S-CAD was found in 64 patients (6.9%) and ns-CAD in 114 (12.3%). Among patients with s-CAD, significant stenosis was found in the left anterior descendent (LAD) coronary artery in 38, right coronary artery in 22 and circumflex coronary artery in 24. 3 patients were reported to have s-CAD in the left main coronary artery. 24 patients underwent revascularization at the initial angiogram. 69.1% of c-angio patients were discharged on statins. <h3>Conclusion</h3> DTCAD was present in 19.2% of HT, being s-CAD in 6.9%. The most common affected artery was the LAD. Factors related to DTCAD and prognostic significance of this finding will be further investigated
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