Determinants of coronary artery disease in liver transplant candidates.
OBJECTIVE
The potential for perioperative and late cardiovascular complications in liver transplant candidates makes careful preoperative risk assessment imperative. We sought to identify the determinants of coronary artery disease in liver transplant candidates.


METHODS
Liver transplant candidates with end-stage liver disease who were more than 40 years old and undergoing coronary angiography were retrospectively included in this study. Patients with known coronary heart disease or valvular heart disease were excluded. Symptoms, coronary artery disease risk factors, blood tests, electrocardiogram, echocardiography, treadmill stress test, myocardial perfusion scintigraphy, and coronary angiography results were recorded. A multivariable logistic regression model was used to assess the independent predictors of coronary artery disease.


RESULTS
A total of 139 patients (mean age, 52 +/- 8; 110 male [79%]) were included in the analysis. Coronary angiography revealed that 13 patients (9.4%) had coronary artery disease. The frequency of diabetes mellitus, stable angina symptoms, positive smoking status, presence of 2 or more risk factors for coronary artery disease, and mean low-density lipoprotein cholesterol levels were significantly higher in patients with coronary artery disease than in patients without coronary artery disease. The electrocardiogram, echocardiography, and noninvasive stress test results were not valuable tools in liver transplant candidates for the diagnosis of coronary artery disease. In multivariate analysis, typical angina symptoms and low-density lipoproteins cholesterol levels appeared to be independent factors that were predictive of coronary artery disease.


CONCLUSIONS
Typical anginal symptoms and low-density lipoprotein cholesterol levels seem to be the best predictors of coronary artery disease in liver transplant candidates.
Aydinalp
Alp
A
Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey. alpaydinalp@superonline.com
Atar
Ilyas
I
Bal
Ugur
U
Aktas
Ayse
A
Ertan
Cagtay
C
Atar
Asli
A
Yildirir
Aylin
A
Ozin
Bulent
B
Muderrisoglu
Haldun
H
Haberal
Mehmet
M
D000328:Adult; D000787:Angina Pectoris / Q000209:etiology; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016896:Treatment Outcome; D014421:Turkey
D015415:Biomarkers; D008078:Cholesterol, LDL