TY - JOUR
T1 - Presence of any degree of coronary artery disease among liver transplant candidates is associated with increased rate of post-transplant major adverse cardiac events
AU - Hughes, Dempsey L.
AU - Rice, Jonathan D.
AU - Burton, James R.
AU - Jin, Ying
AU - Peterson, Ryan A.
AU - Ambardekar, Amrut V.
AU - Pomposelli, James J.
AU - Pomfret, Elizabeth A.
AU - Kriss, Michael S.
N1 - Publisher Copyright:
© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2020/11
Y1 - 2020/11
N2 - The impact of coronary artery disease (CAD) among liver transplant candidates (LTC) on post-LT clinical outcomes remains unclear. The aim of this study is to determine association of presence and severity of CAD on post-LT major adverse cardiac events (MACE) including cardiac-associated mortality. We conducted a retrospective cohort analysis of 231 patients who underwent diagnostic coronary angiogram (DCA) during their LT evaluation at a tertiary medical center from 2012-2017. Patients were analyzed based on degree of CAD (no CAD, non-obstructive CAD [< 50% stenosis], obstructive CAD [≥50% stenosis]) per DCA results. MACE were noted at 30 days, 1 year, 3 years, and 5 years post-LT, and Kaplan-Meier curves were used to determine post-LT MACE-free probability. LTC with any CAD, including non-obstructive CAD, had lower MACE-free probability at all post-LT time points (0.94 vs 0.65 at 30 days, P =.001; 0.87 vs 0.59 at 1 year, P =.002; 0.87 vs 0.41 at 3 years, P <.001; 0.87 vs 0.37 at 5 years, P <.001). Identification of and medical intervention for non-obstructive CAD should be considered in all LTC, though further studies are necessary to determine optimal medical interventions to mitigate MACE risk in this cohort.
AB - The impact of coronary artery disease (CAD) among liver transplant candidates (LTC) on post-LT clinical outcomes remains unclear. The aim of this study is to determine association of presence and severity of CAD on post-LT major adverse cardiac events (MACE) including cardiac-associated mortality. We conducted a retrospective cohort analysis of 231 patients who underwent diagnostic coronary angiogram (DCA) during their LT evaluation at a tertiary medical center from 2012-2017. Patients were analyzed based on degree of CAD (no CAD, non-obstructive CAD [< 50% stenosis], obstructive CAD [≥50% stenosis]) per DCA results. MACE were noted at 30 days, 1 year, 3 years, and 5 years post-LT, and Kaplan-Meier curves were used to determine post-LT MACE-free probability. LTC with any CAD, including non-obstructive CAD, had lower MACE-free probability at all post-LT time points (0.94 vs 0.65 at 30 days, P =.001; 0.87 vs 0.59 at 1 year, P =.002; 0.87 vs 0.41 at 3 years, P <.001; 0.87 vs 0.37 at 5 years, P <.001). Identification of and medical intervention for non-obstructive CAD should be considered in all LTC, though further studies are necessary to determine optimal medical interventions to mitigate MACE risk in this cohort.
KW - cirrhosis
KW - coronary angiography
KW - coronary artery disease
KW - liver transplantation
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U2 - 10.1111/ctr.14077
DO - 10.1111/ctr.14077
M3 - Article
C2 - 32939833
AN - SCOPUS:85091605151
VL - 34
JO - Clinical Transplantation
JF - Clinical Transplantation
SN - 0902-0063
IS - 11
M1 - e14077
ER -