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Your BMI is 30 or higher, and you have diastolic heart failure, high blood pressure, chronic kidney disease, prediabetes, a previous heart attack or stroke or peripheral artery disease

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Options for managing tolerance include a brief dose reduction for 4 to 8 weeks ("drug holiday" at a lower dose, not complete cessation), lifestyle optimization to maximize the medication effect, evaluation for other contributing factors (thyroid function, cortisol, sleep quality, medication interactions), and consideration of adding a complementary compound to address specific aspects of the plateau

At follow-up (mean follow-up 5.0 years), there was reduced graft survival in patients with MVI not meeting criteria for AMR compared to patients without rejection, an intermediate risk between AMR and non-rejection

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