Coronary artery disease and its risk factors in patients presenting for liver transplantation

• Published in: Journal of clinical anesthesia 2013-12, Vol.25 (8), p.618-623
• Main Authors: Gologorsky, Edward, MD, FASE, Pretto, Ernesto A., MD, MPH, Fukazawa, Kyota, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Alcoholism - complications; Alcoholism - epidemiology; Anesthesia & Perioperative Care; Anesthesia preoperative assessment; Coronary artery disease; Coronary Artery Disease - epidemiology; Coronary Artery Disease - etiology; Databases, Factual; Diabetes; End Stage Liver Disease - epidemiology; End Stage Liver Disease - etiology; End Stage Liver Disease - surgery; Fatty Liver - complications; Fatty Liver - epidemiology; Fatty Liver - surgery; Female; Hepatitis B virus; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - epidemiology; Hepatitis B, Chronic - surgery; Hepatitis C virus; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - epidemiology; Hepatitis C, Chronic - surgery; Humans; Liver cirrhosis; Liver Cirrhosis, Alcoholic - complications; Liver Cirrhosis, Alcoholic - epidemiology; Liver Cirrhosis, Alcoholic - surgery; Liver Cirrhosis, Biliary - complications; Liver Cirrhosis, Biliary - epidemiology; Liver Cirrhosis, Biliary - surgery; Liver Transplantation; Male; Middle Aged; Pain Medicine; Prevalence; Retrospective Studies; Risk Factors; Studies; Transplants & implants; United States - epidemiology; Young Adult
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2013.06.001

Abstract Study Objective To determine the distribution of coronary artery disease (CAD) and its risk factors across the various etiologies of end-stage liver disease, and to elucidate the relationship between severe alcohol consumption and CAD. Design Retrospective multicenter study analysis. Setting National Standard Transplant Analysis and Research file data. Measurements Data from all primary adult orthotopic liver transplant recipients during the period from 2004 through 2006 were studied. Data were divided into 5 groups according to each patient’s etiology of end-stage liver disease. The prevalence of CAD and the distribution of its risk factors were compared among groups. Main results 17,482 cases were studied. The incidence of CAD was highest in nonalcoholic hepatic steatosis (7.4%) and lowest in biliary cirrhosis (1.7%). No difference in prevalence of CAD and its risk factors was noted between the viral and alcoholic etiologies (Hepatitis C 2.7%, Hepatitis B 2.3%, and alcoholic cirrhosis 2.9%). Conclusions Prevalence of CAD and the distribution of CAD risk factors in patients with severe alcohol consumption were similar to patients with viral hepatitis. CAD was most prevalent in patients with hepatic steatosis. This study argues against the notion of decreased expression and progression of CAD in patients with alcoholic cirrhosis presenting for liver transplantation.