High Coronary Artery Calcium Score Is Associated With Increased Major Adverse Cardiac Events After Liver Transplantation

Amanda Su, MD; Erik Almazan, MD,; Vorada Sakulsaengprapha, MD; Jessica Shay, MD; Ilan Wittstein, MD; Muhammad Hammami, MD; Aliaksei Pustavoitau, MD; Nicole Rizkalla, MD; Saleh Alqahtani, MD; Tinsay Woreta, MD; James P. Hamilton, MD; Ruhail Kohli, MD; Shane E. Ottmann, MD; Ahmet Gurakar, MD; Po-Hung Chen, MD

doi:10.1097/TXD.0000000000001426

Transplantation Direct (Feb 2023)

High Coronary Artery Calcium Score Is Associated With Increased Major Adverse Cardiac Events After Liver Transplantation

Amanda Su, MD,
Erik Almazan, MD,,
Vorada Sakulsaengprapha, MD,
Jessica Shay, MD,
Ilan Wittstein, MD,
Muhammad Hammami, MD,
Aliaksei Pustavoitau, MD,
Nicole Rizkalla, MD,
Saleh Alqahtani, MD,
Tinsay Woreta, MD,
James P. Hamilton, MD,
Ruhail Kohli, MD,
Shane E. Ottmann, MD,
Ahmet Gurakar, MD,
Po-Hung Chen, MD

Affiliations

Amanda Su, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Erik Almazan, MD,: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Vorada Sakulsaengprapha, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Jessica Shay, MD: 2 Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA.
Ilan Wittstein, MD: 3 Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Muhammad Hammami, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Aliaksei Pustavoitau, MD: 4 Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD.
Nicole Rizkalla, MD: 4 Department of Anesthesiology, Johns Hopkins University School of Medicine, Baltimore, MD.
Saleh Alqahtani, MD: 5 Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Tinsay Woreta, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
James P. Hamilton, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Ruhail Kohli, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Shane E. Ottmann, MD: 6 Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD.
Ahmet Gurakar, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Po-Hung Chen, MD: 1 Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.

DOI: https://doi.org/10.1097/TXD.0000000000001426
Journal volume & issue: Vol. 9, no. 2
p. e1426

Abstract

Read online

Background. Liver transplantation (LT) candidates frequently have multiple cardiovascular risk factors, and cardiovascular disease is a major cause of morbidity and mortality after LT. Coronary artery calcium (CAC) scores are a noninvasive assessment of coronary artery disease using computed tomography. This study examines CAC scores and cardiac risk factors and their association with outcomes after LT. Methods. Patients who underwent LT between January 2010 and June 2019 with a pretransplant CAC score were included in this study. Patients were divided by CAC score into 4 groups (CAC score 0, CAC score 1–100, CAC score 101–400, CAC score >400). Major adverse cardiovascular events (MACEs) were defined as myocardial infarction, stroke, revascularization, heart failure, atrial fibrillation, and cardiovascular death. Associations between CAC score and MACE or all-cause mortality within the 5-y post-LT follow-up period were analyzed using Cox regression. Statistical significance was defined as P 400 group, with a hazard ratio 2.58 (95% confidence interval 1.05, 6.29). Conclusions. CAC score was not associated with all-cause mortality. Patients with CAC score >400 had an increase in MACEs within the 5-y follow-up period compared with patients with a CAC score = 0. Further research with larger cohorts is needed to examine cardiac risk stratification in this vulnerable patient population.

Published in Transplantation Direct

ISSN: 2373-8731 (Online)
Publisher: Wolters Kluwer
Country of publisher: United States
LCC subjects: Medicine: Surgery
Website: http://journals.lww.com/transplantationdirect/Pages/default.aspx

About the journal