title: Impact of pre-operative coronary artery disease on cardiovascular events following lung transplantation.
abstract: BACKGROUND
  This study examined the correlation between pre-operative coronary artery disease (CAD) and post-operative cardiovascular events in lung transplant recipients.
  
  
  METHODS
  Consecutive isolated lung transplant recipients from 2007 to 2013 in our institution were identified and categorized as having significant CAD (≥ 50% coronary stenosis in at least 1 artery or history of coronary revascularization) or no-mild CAD. Patient records and death index data were analyzed for a median of 2 years for death or cardiovascular events, including coronary, cerebrovascular, and peripheral artery events.
  
  
  RESULTS
  The study comprised 280 patients (62% male) with mean age of 60 ± 10 years. Cardiovascular events occurred in 5.7% (16 of 280) of the entire cohort. Patients with significant CAD had a higher annualized rate of cardiovascular events than those with no-mild CAD (11.9% vs 0.6%; p < 0.001). Significant CAD was an independent predictor of cardiovascular events (hazard ratio, 20.32; 95% confidence interval, 5.79-71.26; p < 0.001) but not all-cause mortality (log-rank p = 0.66). Adding significant CAD to clinical risk factors gave incremental prognostic performance compared with clinical risk factors alone (p < 0.001 for increase in global chi-square).
  
  
  CONCLUSIONS
  Selected lung transplant candidates with significant CAD can undergo transplantation with equal mortality risk to those without CAD but are at a higher risk of non-fatal cardiovascular events. These data support the current practice of accepting a selected group of patients with CAD for lung transplantation and suggest that they should be monitored early and treated to prevent cardiovascular complications.
authors.affiliation: Department of Medicine. Electronic address: supersoon@gmail.com.
authors.forename: Kongkiat
authors.initials: K
authors.lastname: Chaikriangkrai
authors.affiliation: Department of Medicine; Methodist J.C. Walter Jr. Transplant Center.
authors.forename: Soma
authors.initials: S
authors.lastname: Jyothula
authors.affiliation: Department of Medicine.
authors.forename: Hye Yeon
authors.initials: HY
authors.lastname: Jhun
authors.affiliation: Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.
authors.forename: Jerry
authors.initials: J
authors.lastname: Estep
authors.affiliation: Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.
authors.forename: Matthias
authors.initials: M
authors.lastname: Loebe
authors.affiliation: Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas.
authors.forename: Scott
authors.initials: S
authors.lastname: Scheinin
authors.affiliation: Methodist DeBakey Heart & Vascular Center, Houston Methodist Hospital, Houston, Texas; Escuela de Medicina, Tecnologico de Monterrey, Monterrey, Nuevo León, Mexico.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Torre-Amione
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D015994:Incidence; D008171:Lung Diseases / Q000150:complications* / Q000601:surgery; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate / Q000639:trends; D013781:Texas / Q000453:epidemiology
keywords: cardiovascular events; coronary artery disease; correlation; lung transplantation; mortality; preoperative; prognosis; stroke; survival