title: Coronary Computed Tomographic Angiography in the Evaluation of Liver Transplant Candidates.
abstract: The feasibility, safety, and value of coronary computed tomographic angiography (CCTA) in evaluating orthotopic liver transplant (OLT) candidates are unknown. We studied a cohort of consecutive OLT candidates with intermediate-to-high risk of coronary artery disease (CAD). Intermediate risk candidates received CCTA, and those at high risk or with abnormal noninvasive testing underwent invasive coronary angiography (ICA). One hundred consecutive patients were evaluated. Fifty patients underwent a CCTA, 71.4% were β-blocked, the image quality was "good" or "excellent" in 71.4% of cases, and there was no event of significant contrast-induced nephropathy. Twenty (20%) patients were found to have severe CAD (≥70% stenosis) by CCTA and/or ICA. Independent predictors of severe CAD were age (odds ratio [OR] = 5.4 per 10-year increment, 95% confidence interval [CI] = 1.7-17.0; P = .004), dyslipidemia (OR = 12.3, 95% CI = 2.6-57.6; P = .001), and chest pain (OR = 6.0, 95% CI = 1.2-29.1; P = .03). Implementing CCTA in the evaluation of intermediate/high CAD risk OLT candidates is challenging but feasible and seems safe.
authors.affiliation: Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Marie-France
authors.initials: MF
authors.lastname: Poulin
authors.affiliation: Division of Transplantation, Department of General Surgery, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Edie Y
authors.initials: EY
authors.lastname: Chan
authors.affiliation: Division of Cardiology, Rush University Medical Center, Chicago, IL, USA Division of Adult Cardiology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA rami_doukky@rush.edu.
authors.forename: Rami
authors.initials: R
authors.lastname: Doukky
mesh_terms: D000368:Aged; D000465:Algorithms; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging*; D019091:Critical Pathways; D058625:End Stage Liver Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016031:Liver Transplantation; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000009:adverse effects; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index
keywords: coronary angiography; coronary artery disease; coronary computed tomographic angiography; end-stage liver disease; liver transplant