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Full-Text Articles in Cardiology
Corticosteroid Weaning In Stable Heart Transplant Patients: Guidance By Serum Cortisol Level, David A. Baran, Cheryl Rosenfeld, Mark J. Zucker
Corticosteroid Weaning In Stable Heart Transplant Patients: Guidance By Serum Cortisol Level, David A. Baran, Cheryl Rosenfeld, Mark J. Zucker
Touro College of Osteopathic Medicine (Middletown) Publications and Research
Background: Despite earlier studies describing the feasibility of steroid weaning in heart transplant patients, the majority of patients are maintained on steroid therapy for life. We examined a strategy based on a single morning serum cortisol measurement.
Methods: We assigned stable posttransplant patients, who were maintained on tacrolimus, mycophenolate mofetil, and corticosteroids, into one of two groups based on a screening morning cortisol level. Patients with a cortisol < 8 micrograms/deciliter were assigned to a "maintenance" group and the others were assigned to the weaning group and steroids were tapered off over 4-6 weeks. Patients were monitored on subsequent office visits for adrenal insufficiency and allograft rejection.
Results: Thirty-one patients were enrolled (6 patients in the maintenance group and 25 in the steroid-weaning group). Mean follow-up was 10.2 ± 4 years for the weaning group and 9.0 ± 4.9 …