title: Obstructive coronary disease in patients with chronic liver disease awaiting liver transplantation.
abstract: BACKGROUND
  Advanced liver failure (ALF) usually presents hypocholesterolemia. Nevertheless, some patients with ALF develops major coronary obstructive diseases with consequent increased risk or contraindication to liver transplantation.
  
  
  OBJECTIVE
  To analyze the contribution of classical risk factors for coronary artery disease (CAD) in patients with ALF with and without obstructive coronary disease.
  
  
  METHODS
  Evaluation of risk factors for CAD in 119 patients in a referral center for liver transplantation, with the following characteristics: patients older than 40 years of age with ALV who underwent coronary angiography.
  
  
  RESULTS
  Obstructive coronary disease was detected in 21 (17.6%) of the cases. These patients had really low cholesterol levels, of which 129.0 ± 53.5 mg/dl averaging 117.0 mg/dl in liver disease patients with normal coronary arteries and 135.4 ± 51.7 mg/dl averaging 122.0 mg/dl in liver disease patients with obstructive coronary artery disease (P = 0.8215). In multivariate logistic regression, age, sex, body mass index and the presence of diabetes, smoking and alcohol consumption were not statistically significant in distinguishing groups. Nor was there an association with the etiology of the ALF. In turn, hypertension was proven to be relevant in association with CAD (P = 0.0474).
  
  
  CONCLUSIONS
  Only hypertension was a risk factor with statistical significance for the development of CAD in patients with ALF awaiting liver transplantation. Because it is a modifiable risk factor, this finding guides the practice of therapeutic attitudes in an attempt to prevent or delay the development of CAD in these patients.
authors.affiliation: Faculdade de Medicina de São José do Rio Preto, SP, Brazil. moacirgodoy@cardiol.br
authors.forename: Moacir Fernandes de
authors.initials: MF
authors.lastname: Godoy
authors.forename: Patricia de Oliveira
authors.initials: Pde O
authors.lastname: Roveri
authors.forename: Marcio Antonio dos
authors.initials: MA
authors.lastname: Santos
authors.forename: Flavio Correa
authors.initials: FC
authors.lastname: Pivatelli
authors.forename: Rita de Cássia Martins Alves da
authors.initials: Rde C
authors.lastname: Silva
authors.forename: Renato Ferreira da
authors.initials: RF
authors.lastname: Silva
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000150:complications*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D008107:Liver Diseases / Q000150:complications* / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D012307:Risk Factors