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Introduction: Cardiac allograft vasculopathy (CAV) limits long‐term survival in heart transplant (HTx) recipients. The use of biomarkers in CAV surveillance has been studied, but none are used in clinical practice. The predictive value of high‐sensitivity troponin I (hsTnI) has not been extensively investigated in HTx recipients. Methods: HTx patients undergoing surveillance coronary angiograms and enrolled in the Emory Cardiovascular Biobank had plasma hsTnI measured. CAV grade was assessed using ISHLT nomenclature. Multivariable cumulative link mixed modeling was performed to determine association between hsTnI level and CAV grade. Patients were followed for adverse outcomes over a median 10‐year period. Kaplan‐Meier survival analysis and Cox proportional hazard modeling were performed. Results: Three hundred and seventy‐two angiograms were analyzed in 156 patients at a median 8.9 years after transplant. hsTnI levels were positively correlated with concurrent CAV grade after adjustment for age, age at transplant, sex, BMI, hypertension, diabetes, hyperlipidemia, estimated glomerular filtration rate, and history of acute cellular rejection (p =.016). In an adjusted Cox proportional hazard model, initial hsTnI level above the median (4.9 pg/mL) remained a predictor of re‐transplantation or death (hazard ratio 1.82; 95% confidence interval 1.16–2.90; p =.01). Conclusion: An elevated hsTnI level reflects severity of CAV and is associated with poor long‐term outcomes in patients with HTx. [ABSTRACT FROM AUTHOR]

Background: Caregiver support is considered necessary after heart transplant (HT) and left ventricular assist device (LVAD) for patients with end‐stage heart failure (HF). Few studies have demonstrated how caregivers differ by gender and race, and whether that impacts therapy eligibility. Methods: We examined caregiver relationships among 674 patients (32% women, 55% Black) evaluated at Emory University from 2011 to 2017. Therapy readiness was assessed using the Stanford Integrated Assessment for Transplant (SIPAT). Evaluation outcome according to caregiver relationship was compared using χ2 analysis. Multivariable logistic regression determined the association between caregiver and eligibility according to gender and race. Results: Women and Black patients were less likely to have spouses as their support person (P <.001). Women were less likely to be considered eligible for advanced therapies (adjusted odds ratio [aOR].64, 95% confidence interval [CI].46–.89; P =.008), with Black women having lower eligibility than White women (aOR.28, 95% CI.11–.72; P =.008). Social support and SIPAT scores did not significantly influence eligibility by gender or race. Conclusion: Lack of caregiver support is considered a relative contraindication to advanced therapies. Type of caregiver in our cohort varied according to race and gender but did not explain differences in eligibility for advanced therapies. [ABSTRACT FROM AUTHOR]