Figure 1
Strobe flow diagram. Abbreviation: HT, heart transplantation.
Table 1
Baseline characteristics.
| VARIABLE | OVERALL (n = 260) |
|---|---|
| Sociodemographic characteristics | |
| Age, years | 51.0 (39.5, 59.0) |
| Female | 58 (22.3%) |
| Male | 202 (77.7%) |
| Main etiology | |
| Chagas | 7 (2.7%) |
| Hypertrophic | 5 (1.9%) |
| IDC | 107 (41.3%) |
| IC | 70 (27.0%) |
| Restrictive | 5 (1.9%) |
| VHD | 25 (9.7%) |
| Viral | 9 (3.5%) |
| Others | 32 (12.3%) |
| Comorbidities | |
| HTN | 125 (48.3%) |
| CKD | 34 (13.1%) |
| Chronic obstructive pulmonary disease | 6 (2.3%) |
| Deep venous thrombosis | 9 (3.5%) |
| DM | 49 (18.9%) |
| Neoplasia | 7 (2.7%) |
| Occlusive arterial disease | 12 (4.6%) |
| Pulmonary embolism | 20 (7.7%) |
| Stroke | 23 (8.9%) |
| Transient ischemic attack | 9 (3.5%) |
[i] Data are shown as n (%) or median (interquartile range). Other categories include arrhythmia, cardiotoxicity, chemotherapy, infiltrative, inherited, and peripartum. Abbreviations: CKD, chronic kidney disease; DM, diabetes mellitus; HTN, hypertension; IC, ischemic cardiomyopathy; IDC, idiopathic/dilated cardiomyopathy; VHD, valvular heart disease.
Table 2
Etiologies by age group.
| VARIABLE | <40 (N = 67) | 40–49 (N = 53) | 50–59 (N = 86) | ≥60 (N = 54) |
|---|---|---|---|---|
| Chagas | 2 (3.0%) | 3 (5.7%) | 1 (1.2%) | 1 (1.9%) |
| Hypertrophic | 1 (1.5%) | 2 (3.8%) | 1 (1.2%) | 1 (1.9%) |
| IDC | 30 (44.8%) | 21 (39.6%) | 38 (44.2%) | 18 (33.3%) |
| IC | 5 (7.5%) | 9 (17.0%) | 30 (34.9%) | 26 (48.1%) |
| Restrictive | 1 (1.5%) | 3 (5.7%) | 1 (1.2%) | 0 (0.0%) |
| VHD | 5 (7.5%) | 10 (18.9%) | 6 (7.0%) | 4 (7.4%) |
| Viral | 6 (9.0%) | 2 (3.8%) | 0 (0.0%) | 1 (1.9%) |
| Others | 17 (25.4%) | 3 (5.7%) | 9 (10.5%) | 3 (5.6%) |
[i] Data are shown as n (%). Other categories include arrhythmia, cardiotoxicity, chemotherapy, infiltrative, inherited, and peripartum. Abbreviations: IC, ischemic cardiomyopathy; IDC, idiopathic/dilated cardiomyopathy; VHD, valvular heart disease.
Figure 2
Survival curves based on survival status at different time frames.
Figure 3
Adjusted age-specific survival curve.
Figure 4
Survival curves stratified by five-year periods based on the timing of the HT.
*Patients who underwent HT after 2020 were excluded from this analysis because they had not completed five years of follow-up at the time of inclusion. Abbreviation: HT, heart transplantation.
Figure 5
Forest plot parsimonious model.
*Events-per-variable ratio of 53. Abbreviations: CKD, chronic kidney disease; DM, diabetes mellitus; HR, hazard ratio.
Table 3
Donor and perioperative risk factors for post-transplant mortality.
| VARIABLE | HR UNADJUSTED (n = 260) | CI (95%) UNADJUSTED | p-VALUE UNADJUSTED | HR MODEL 2 (n = 255) | CI (95%) MODEL 2 | p-VALUE MODEL 2 |
|---|---|---|---|---|---|---|
| Perioperative variable | ||||||
| Inotropics | 1.32 | (0.96–1.83) | 0.090 | – | – | – |
| Ischemic time, minutes | ||||||
| ≤200 | – | – | – | – | – | – |
| 201–400 | 1.1 | (0.84–1.62) | 0.347 | – | – | – |
| >400 | 1.31 | (0.48–3.57) | 0.601 | – | – | – |
| Ischemic time, minutes | ||||||
| ≤150 | – | – | – | – | – | – |
| >150 | 1.27 | (0.89–1.82) | 0.188 | – | – | – |
| Year of transplant | ||||||
| 1995–2000 | – | – | – | – | – | – |
| 2001–2005 | 1.14 | (0.65–2.00) | 0.649 | – | – | – |
| 2006–2010 | 1.12 | (0.67–1.87) | 0.673 | – | – | – |
| 2011–2015 | 0.99 | (0.55–1.76) | 0.968 | – | – | – |
| 2016–2020 | 1.52 | (0.87–2.66) | 0.145 | – | – | – |
| 2021–2024 | 1.02 | (0.48–2.21) | 0.950 | – | – | – |
| Donor variables | ||||||
| Donor age of death | 1.00 | (0.98–1.02) | 0.880 | – | – | – |
| Donor DM | 0.76 | (0.11–5.49) | 0.789 | – | – | – |
| Donor HTN | 0.95 | (0.24–3.85) | 0.944 | – | – | – |
| Donor smoking | 0.56 | (0.29–1.07) | 0.080 | – | – | – |
Table 4
Recipient risk factors for post-transplant mortality.
| VARIABLE | HR UNADJUSTED (n = 260) | CI (95%) UNADJUSTED | p-VALUE UNADJUSTED | HR MODEL 2 (n = 255) | CI (95%) MODEL 2 | p-VALUE MODEL 2 |
|---|---|---|---|---|---|---|
| Recipient variables | ||||||
| CKD | 2.01 | (1.30–3.10) | 0.002 | 1.79 | (1.15–2.79) | 0.010 |
| Creatinine | 1.05 | (0.91–1.22) | 0.511 | – | – | – |
| DM | 1.69 | (1.15–2.49) | 0.008 | 1.46 | (0.97–2.22) | 0.072 |
| HTN | 0.95 | (0.70–1.30) | 0.767 | – | – | – |
| LVEF categorized | ||||||
| Reduced (<40%) | – | – | – | – | – | – |
| Mildly reduced (40%–49%) | 0.78 | (0.19–3.16) | 0.731 | – | – | – |
| Preserved (≥50%) | 1.33 | (0.54–3.25) | 0.535 | – | – | – |
| Recipient age, years | ||||||
| <40 | – | – | – | – | – | – |
| 40–49 | 1.02 | (0.63–1.64) | 0.936 | 1.03 | (0.63–1.66) | 0.911 |
| 50–59 | 1.32 | (0.87–2.00) | 0.195 | 1.17 | (0.75–1.81) | 0.495 |
| ≥60 | 1.63 | (1.03–2.58) | 0.350 | 1.39 | (0.85–2.28) | 0.189 |
| Sex | ||||||
| Female | – | – | – | – | – | – |
| Male | 0.75 | (0.53–1.07) | 0.113 | – | – | – |
| Recipient previous heart disease | ||||||
| IC | – | – | – | – | – | – |
| IDH | 0.80 | (0.55–1.16) | 0.239 | – | – | – |
| Other underlying heart disease | 0.71 | (0.45–1.13) | 0.152 | – | – | – |
| VHC | 1.08 | (0.62–1.87) | 0.794 | – | – | – |
[i] *Both Tables 3 and 4 are based on the same parsimonious model (Model 2). Abbreviations: CKD, chronic kidney disease; DM, diabetes mellitus; HR, hazard ratio; HTN, hypertension; IC, ischemic cardiomyopathy; IDC, idiopathic/dilated cardiomyopathy; LVEF, left ventricular ejection fraction; VHD, valvular heart disease.