Cardiac response to early conversion from calcineurin inhibitor to everolimus in renal transplant recipients: An echocardiographic substudy of the randomized controlled CENTRAL trial.
Murbraech K, Holdaas H, et al.Transplantation 2014;97(2):184-8
Aims
To investigate whether an early conversion from cyclosporine A (CsA) to everolimus would reduce left ventricular hypertrophy (LVH) and improve left ventricular systolic and diastolic function.
Interventions
Participants were administered with either everolimus following conversion from CsA, or continued CsA.
Participants
44 de novo kidney transplant recipients.
Outcomes
The outcomes included changes in echocardiographic markers of LVH, left ventricular mass index and parameters of systolic and diastolic function.
Follow-up
1 year.
CET Conclusions
This study is unfortunately compromised by a small sample size (63 patients). Of the original sample 18 patients changed medication, hence this is a per protocol analysis of 44 patients. Many more patients switched allocation in the everolimus arm than the CNI arm, mostly due to adverse events (15 versus 3). There were no differences in cardiac response to the medication prescribed, including blood pressure, left ventricular hypertrophy and left ventricular function. If anything there was a slightly improved left ventricular diastolic function with cyclosporine.
Data analysis
Per protocol analysis
Quality notes
Methods assessed in Mjornstedt et al. Improved Renal Function After Early Conversion From a Calcineurin Inhibitor to Everolimus: a Randomized Trial in Kidney Transplantation. American Journal of Transplantation. 2012; 12(10): 2744-53. Data analysis taken from current paper Murbraech et al.
Trial registration
ClinicalTrials.gov - NCT00634920