{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T20:33:38Z","timestamp":1776890018678,"version":"3.51.2"},"reference-count":32,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002701","name":"Ministry of Education","doi-asserted-by":"publisher","award":["NRF\u20102022R1C1C1011730"],"award-info":[{"award-number":["NRF\u20102022R1C1C1011730"]}],"id":[{"id":"10.13039\/501100002701","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Kidney transplant recipients (KTRs) are at high risk for cardiovascular disease due to the long\u2010term use of immunosuppressive therapy. This study aims to evaluate the long\u2010term impact of sirolimus on cardiovascular outcomes in Korean KTRs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>From a cohort of 7180 eligible KTRs identified from 2010 to 2021, 387 KTRs who received sirolimus were included. To control for confounding variables, propensity score matching was applied, and the landmark method was used to address immortal time bias. The primary outcome was major adverse cardiovascular events (MACE), defined as a composite of myocardial infarction, coronary revascularization, ischaemic stroke and all\u2010cause mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The analysis showed no significant difference in MACE between the sirolimus\u2010treated and untreated groups (hazard ratio, 1.40; 95% confidence interval, .77\u20132.55), despite a higher incidence of dyslipidaemia in the sirolimus\u2010treated group. However, subgroup analysis revealed an increased MACE risk in KTRs with pre\u2010transplant congestive heart failure (CHF) who were treated with sirolimus (hazard ratio, 6.22; 95% confidence interval, 1.78\u201321.74), while no significant differences were found in other subgroups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>These findings suggest that while sirolimus can be a viable option for immunosuppression, it should be used cautiously in those with pre\u2010existing CHF.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.70027","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T11:48:27Z","timestamp":1742384907000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Impact of sirolimus on long\u2010term adverse cardiovascular outcomes in kidney transplant recipients: A nationwide cohort study"],"prefix":"10.1111","volume":"55","author":[{"given":"Jinhyun","family":"Park","sequence":"first","affiliation":[{"name":"College of Pharmacy Daegu Catholic University  Gyeongsan Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wonhui","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Statistics Daegu University  Gyeongsan Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinseub","family":"Hwang","sequence":"additional","affiliation":[{"name":"Department of Statistics Daegu University  Gyeongsan Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ha Young","family":"Jang","sequence":"additional","affiliation":[{"name":"College of Pharmacy Gachon University  Incheon Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Pharmacy Daegu Catholic University  Gyeongsan Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Young\u2010Mi","family":"Ah","sequence":"additional","affiliation":[{"name":"College of Pharmacy Yeungnam University  Gyeongsan Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin\u2010Won","family":"Kwon","sequence":"additional","affiliation":[{"name":"BK21 FOUR Community\u2010Based Intelligent Novel Drug Discovery Education Unit, College of Pharmacy and Research Institute of Pharmaceutical Sciences Kyungpook National University  Daegu Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyung Hee","family":"Choi","sequence":"additional","affiliation":[{"name":"College of Pharmacy Gachon University  Incheon Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3687-4052","authenticated-orcid":false,"given":"Yun\u2010Kyoung","family":"Song","sequence":"additional","affiliation":[{"name":"College of Pharmacy The Catholic University of Korea  Bucheon Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41581-022-00616-6"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy174"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2020050566"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000003990"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2019.06.026"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23147707"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2009.02834.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.3389\/fcvm.2022.981838"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12852"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-022-25070-z"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007111202"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1074248412469298"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2022.05.017"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.3346\/jkms.2010.25.11.1589"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-017-1500-z"},{"key":"e_1_2_9_17_1","unstructured":"Ministry of Health and Welfare.Partial Amendment on the Details Regarding the Standards and Methods of Applying Medical Care Benefits.2022. 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