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Presence of any degree of coronary artery disease among liver transplant candidates is associated with increased rate of post‐transplant major adverse cardiac events
Author(s) -
Hughes Dempsey L.,
Rice Jonathan D.,
Burton James R.,
Jin Ying,
Peterson Ryan A.,
Ambardekar Amrut V.,
Pomposelli James J.,
Pomfret Elizabeth A.,
Kriss Michael S.
Publication year - 2020
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.14077
Subject(s) - mace , medicine , coronary artery disease , cohort , cardiology , liver transplantation , stenosis , retrospective cohort study , transplantation , percutaneous coronary intervention , myocardial infarction
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.