Formato Vancouver:
Delgado Jiménez J, Almenar Bonet L, Paniagua Martín MJ, Gómez Bueno M, Yáñez JF, Arizón Del Prado JM, et al. Influence of steroid dosage, withdrawal, and reinstatement on
survival after heart transplantation: results from the RESTCO study. Transplant
Proc. 2012 Nov;44(9):2679-81.

PMID: 23146492

Contiene 4 referencias

Little information is available regarding the consequences of steroid withdrawal following heart transplantation (HT) in Spain.
METHODS: We analyzed the records of 1068 patients (81.6% men) who underwent HT between 2000 and 2005 in 13 Spanish centers who were aged ≥ 18 years and who survived at least 1 year. Death rates and Kaplan-Meier survival curves for 1 to 5 years post-HT were compared among four groups: groups A and B, patients on steroids throughout the first 5 years post-HT at dosages of ≤ 5 mg/d between 1-year and 5-year follow-up (group A; n = 148), or >5 mg/d for some part of this period (group B; n = 578). Groups C and D were patients from whom steroids were at some point withdrawn including group D (n = 73) with and group C (n = 269) without subsequent reintroduction into the maintenance regimen.
RESULTS: Steroids were withdrawn at 1.6 ± 0.9 years post-HT in group C, and 1.7 ± 1.2 years post-HT in group D. The death rate between 1- and 5-year follow-up (deaths per 1000 person-years) was 44.3% (95% confidence interval 26.2-62.5) in group A, 42.6% (33.7-51.4) in group B, 30.5% (19.6-41.4) in group C, and 47.8% (21.8-73.7) in group D. There was no significant difference among them or among Kaplan-Meier survival curves of the four groups (P = .34 in both cases). Comparison of combined groups C + D with groups A + B showed no evidence of a greater mortality among combined groups C + D.
CONCLUSIONS: The late withdrawal of steroids following HT was not associated with increased mortality.