The incidence of coronary artery disease in heart transplant patients appears to be lower in patients who receive ganciclovir—and are not treated with calcium blockers—immediately after transplantation, according to a study by researchers at Stanford University School of Medicine.
The investigators reached that finding after reanalyzing data they originally gathered to study the role of ganciclovir in inhibiting cytomegalovirus. Although the initial study was not designed to address the potential for ganciclovir to prevent coronary artery disease in transplant patients, lead author Hannah A. Valantine, MD, and colleagues found that patients who took ganciclovir were nearly three times less likely to suffer some blockage of their coronary arteries.
The authors believe the new results are significant enough to warrant a randomized, controlled clinical trial.
"If the results mirror those in the recent analysis, transplant surgeons and patients will have gained a powerful new tool in their quest to make organ transplantation more successful. Additionally, this apparent prevention of coronary artery disease could have important implications for atherosclerosis in nontransplanted hearts," Dr. Valantine said in a statement.
The researchers evaluated 62 patients who were treated with ganciclovir and 59 patients who were given a placebo during the first 28 days after heart transplantation. With a mean follow-up of 4.7 years, coronary artery disease occurred in 43% of the ganciclovir-treated patients and in 60% of patients taking a placebo.
The findings were published on July 6 in Circulation (1999;100:61-66). The initial study testing ganciclovir's potential to inhibit cytomegalovirus was published seven years ago in The New England Journal of Medicine (1992;326:1182-1186).
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