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Cognitive function after heart transplantation: Comparing everolimus‐based and calcineurin inhibitor‐based regimens
Author(s) -
Bürker Britta S.,
Gullestad Lars,
Gude Einar,
Relbo Authen Anne,
Grov Ingelin,
Hol Per K.,
Andreassen Arne K.,
Arora Satish,
Dew Mary Amanda,
Fiane Arnt E.,
Haraldsen Ira R.,
Malt Ulrik F.,
Andersson Stein
Publication year - 2017
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12927
Subject(s) - everolimus , medicine , cognition , calcineurin , immunosuppression , heart transplantation , cognitive test , transplantation , neuropsychology , cohort , oncology , cardiology , psychiatry
Background Studies have shown conflicting results concerning the occurrence of cognitive impairment after successful heart transplantation (HTx). Another unresolved issue is the possible differential impact of immunosuppressants on cognitive function. In this study, we describe cognitive function in a cohort of HTx recipients and subsequently compare cognitive function between subjects on either everolimus‐ or calcineurin inhibitor (CNI)‐based immunosuppression. Methods Cognitive function, covering attention, processing speed, executive functions, memory, and language functions, was assessed with a neuropsychological test battery. Thirty‐seven subjects were included (everolimus group: n=20; CNI group: n=17). The extent of cerebrovascular pathology was assessed with magnetic resonance imaging. Results About 40% of subjects had cognitive impairment, defined as performance at least 1.5 standard deviations below normative mean in one or several cognitive domains. Cerebrovascular pathology was present in 33.3%. There were no statistically significant differences between treatment groups across cognitive domains. Conclusions Given the high prevalence of cognitive impairment in the sample, plus the known negative impact of cognitive impairment on clinical outcome, our results indicate that cognitive assessment should be an integrated part of routine clinical follow‐up after HTx. However, everolimus‐ and CNI‐based immunosuppressive regimens did not show differential impacts on cognitive function.