3 years ago

ental coronary artery calcification seen on low-dose computed tomography is a risk factor for obstructive coronary artery disease in patients undergoing liver transplantation

Thaer Othman, Han Tun, Jassimran S. Bainiwal, Emily S. Andersen, Naga L. Dharmavaram, William S. Schwartzman, Aileen N. Baffo, Brian C. Butera, Newton S. Phuong, Peter Z. Xu, Babak Yasmeh, Nina A. Gertsvolf, Andrew J. Yoon, David M. Shavelle, Parveen K. Garg, Helga M. Van Herle, Jeffrey A. Kahn, Brian Kim

Publication date: Available online 9 November 2018

Source: Transplantation Proceedings

Author(s): Thaer Othman, Han Tun, Jassimran S. Bainiwal, Emily S. Andersen, Naga L. Dharmavaram, William S. Schwartzman, Aileen N. Baffo, Brian C. Butera, Newton S. Phuong, Peter Z. Xu, Babak Yasmeh, Nina A. Gertsvolf, Andrew J. Yoon, David M. Shavelle, Parveen K. Garg, Helga M. Van Herle, Jeffrey A. Kahn, Brian Kim

Abstract

Incidental arterial calcification (Ca) on low-dose computed tomography (CT) prior to liver transplantation (LT) may help identify those at risk for obstructive coronary artery disease (CAD). A single-center, retrospective study of 358 consecutive patients who had undergone LT was performed. Of the 296 patients who met inclusion criteria, 193 patients (65.2%) had CT Ca. Aortic Ca was seen in 116 (39.2%); coronary Ca in 141 (47.6%); and peripheral Ca in 8 patients (2.7%). Patients with coronary Ca were assigned ordinal coronary artery calcification (CAC) scores and classified as mild, moderate, and severe. All-cause mortality was higher in patients with Ca in any location (14.5% vs. 6.8%, P=0.05). Of the patients who underwent coronary angiography, those with obstructive CAD were more likely to have aortic and coronary Ca as compared to patients with non-obstructive or no CAD (85.7% vs. 50.0%, P=0.02 and 92.9% vs. 37.9%, P=<0.001). Severe CAC scores were more frequent in patients with obstructive CAD group (35.7% vs. 0%, <0.001). Any severity coronary Ca had an odds ratio of 11.57 (95% CI 1.61 to 244.92, P=0.04) for obstructive CAD. In conclusion, incidental coronary Ca seen on low-dose CT is a risk factor for obstructive CAD in patients undergoing LT.

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