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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
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. W...
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Published in: | Clinical transplantation 2020-11, Vol.34 (11), p.e14077-n/a |
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description | 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 |
doi_str_mv | 10.1111/ctr.14077 |
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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.</description><identifier>ISSN: 0902-0063</identifier><identifier>EISSN: 1399-0012</identifier><identifier>DOI: 10.1111/ctr.14077</identifier><identifier>PMID: 32939833</identifier><language>eng</language><publisher>Denmark</publisher><subject>cirrhosis ; coronary angiography ; coronary artery disease ; liver transplantation</subject><ispartof>Clinical transplantation, 2020-11, Vol.34 (11), p.e14077-n/a</ispartof><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3257-6a37b43f4660abbd5bcca94943e2585ca24f4cf0d0861a94a8d3fd6634f53f23</citedby><cites>FETCH-LOGICAL-c3257-6a37b43f4660abbd5bcca94943e2585ca24f4cf0d0861a94a8d3fd6634f53f23</cites><orcidid>0000-0002-8467-8745 ; 0000-0002-4229-4858</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32939833$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hughes, Dempsey L.</creatorcontrib><creatorcontrib>Rice, Jonathan D.</creatorcontrib><creatorcontrib>Burton, James R.</creatorcontrib><creatorcontrib>Jin, Ying</creatorcontrib><creatorcontrib>Peterson, Ryan A.</creatorcontrib><creatorcontrib>Ambardekar, Amrut V.</creatorcontrib><creatorcontrib>Pomposelli, James J.</creatorcontrib><creatorcontrib>Pomfret, Elizabeth A.</creatorcontrib><creatorcontrib>Kriss, Michael S.</creatorcontrib><title>Presence of any degree of coronary artery disease among liver transplant candidates is associated with increased rate of post‐transplant major adverse cardiac events</title><title>Clinical transplantation</title><addtitle>Clin Transplant</addtitle><description>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.</description><subject>cirrhosis</subject><subject>coronary angiography</subject><subject>coronary artery disease</subject><subject>liver transplantation</subject><issn>0902-0063</issn><issn>1399-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp1kc9uVCEUh4mxsdPqwhcwLHUxLVy4_5ZmUq1JExsz-5tz4VBp7oWRw7SZnY_gW_S9-iQynWrcyOZw4OOD8GPsrRRnsoxzk9OZ1KJtX7CFVH2_FEJWL9lC9KIq80YdsxOi27LayKZ-xY5V1au-U2rBHq4TEgaDPDoOYcct3iR86kxMMUDacUgZS7GeEAg5zDHc8MnfYeI5QaDNBCFzA8F6CxmJe-JAFI0vneX3Pn_nPpi0P215Kot7_SZSfvz56x_DDLcxcbBFXK4xkKwHw_EOQ6bX7MjBRPjmuZ6y9aeL9epyefX185fVx6ulUVXdLhtQ7aiV000jYBxtPRoDve61wqruagOVdto4YUXXyLIBnVXONo3SrlauUqfs_UG7SfHHFikPsyeDU3kfxi0Nldaq6-q2lQX9cEBNikQJ3bBJfi7_NUgx7GMZSizDUyyFffes3Y4z2r_knxwKcH4A7v2Eu_-bhtX620H5G0VVnGI</recordid><startdate>202011</startdate><enddate>202011</enddate><creator>Hughes, Dempsey L.</creator><creator>Rice, Jonathan D.</creator><creator>Burton, James R.</creator><creator>Jin, Ying</creator><creator>Peterson, Ryan A.</creator><creator>Ambardekar, Amrut V.</creator><creator>Pomposelli, James J.</creator><creator>Pomfret, Elizabeth A.</creator><creator>Kriss, Michael S.</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-8467-8745</orcidid><orcidid>https://orcid.org/0000-0002-4229-4858</orcidid></search><sort><creationdate>202011</creationdate><title>Presence of any degree of coronary artery disease among liver transplant candidates is associated with increased rate of post‐transplant major adverse cardiac events</title><author>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.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3257-6a37b43f4660abbd5bcca94943e2585ca24f4cf0d0861a94a8d3fd6634f53f23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>cirrhosis</topic><topic>coronary angiography</topic><topic>coronary artery disease</topic><topic>liver transplantation</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hughes, Dempsey L.</creatorcontrib><creatorcontrib>Rice, Jonathan D.</creatorcontrib><creatorcontrib>Burton, James R.</creatorcontrib><creatorcontrib>Jin, Ying</creatorcontrib><creatorcontrib>Peterson, Ryan A.</creatorcontrib><creatorcontrib>Ambardekar, Amrut V.</creatorcontrib><creatorcontrib>Pomposelli, James J.</creatorcontrib><creatorcontrib>Pomfret, Elizabeth A.</creatorcontrib><creatorcontrib>Kriss, Michael S.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Clinical transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hughes, Dempsey L.</au><au>Rice, Jonathan D.</au><au>Burton, James R.</au><au>Jin, Ying</au><au>Peterson, Ryan A.</au><au>Ambardekar, Amrut V.</au><au>Pomposelli, James J.</au><au>Pomfret, Elizabeth A.</au><au>Kriss, Michael S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Presence of any degree of coronary artery disease among liver transplant candidates is associated with increased rate of post‐transplant major adverse cardiac events</atitle><jtitle>Clinical transplantation</jtitle><addtitle>Clin Transplant</addtitle><date>2020-11</date><risdate>2020</risdate><volume>34</volume><issue>11</issue><spage>e14077</spage><epage>n/a</epage><pages>e14077-n/a</pages><issn>0902-0063</issn><eissn>1399-0012</eissn><abstract>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.</abstract><cop>Denmark</cop><pmid>32939833</pmid><doi>10.1111/ctr.14077</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-8467-8745</orcidid><orcidid>https://orcid.org/0000-0002-4229-4858</orcidid></addata></record> |
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subjects | cirrhosis coronary angiography coronary artery disease liver transplantation |
title | Presence of any degree of coronary artery disease among liver transplant candidates is associated with increased rate of post‐transplant major adverse cardiac events |
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