title: Coronary computer tomographic angiography for preoperative risk stratification in patients undergoing liver transplantation.
abstract: The assessment of the cardiovascular risk profile in patients with end-stage liver disease is essential prior to liver transplantation (LT) as cardiovascular diseases are major causes of morbidity and mortality in the posttransplant course. The aim of this study was to evaluate the accuracy of a 64-slice coronary computed tomographic angiography (CTA) and coronary calcium scoring (CCS) to predict the postoperative cardiovascular risk of patients assessed for LT. In this single center, observational study we included 54 consecutive patients who were assessed for LT and consequently transplanted. Twenty-four patients (44%) presented with a high CCS above 300 and/or a significant stenosis (>50% percent narrowing due to stenotic plaques) and were further referred to coronary angiography. Three of these patients had a more than 70% LAD stenosis with subsequent angioplasty (n=1) or conservative therapy (n=2). The other patients showed only diffuse CAD without significant stenosis. The remaining 30 patients with normal CTA findings were listed for LT without further tests. None of the 54 patients developed cardiovascular events peri- and postoperatively. This study indicated that CTA combined with CCS is a useful non-invasive imaging technique for pre-LT assessment of coronary artery disease and safe tool in the risk assessment of peri- and postoperative cardiovascular events in patients undergoing LT.
authors.affiliation: Department of Internal Medicine III (Cardiology), Medical University of Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria. daniel.jodocy@klinikum-minden.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Jodocy
authors.forename: Susanne
authors.initials: S
authors.lastname: Abbrederis
authors.forename: Ivo W
authors.initials: IW
authors.lastname: Graziadei
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Vogel
authors.forename: Otmar
authors.initials: O
authors.lastname: Pachinger
authors.forename: Gudrun M
authors.initials: GM
authors.lastname: Feuchtner
authors.forename: Werner
authors.initials: W
authors.lastname: Jaschke
authors.forename: Guy
authors.initials: G
authors.lastname: Friedrich
mesh_terms: D000328:Adult; D000368:Aged; D001317:Austria / Q000453:epidemiology; D017023:Coronary Angiography / Q000706:statistics & numerical data*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000000981:diagnostic imaging* / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011300:Preoperative Care / Q000379:methods / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome