Aydinalp Alp, Atar Ilyas, Bal Ugur, Aktas Ayse, Ertan Cagtay, Atar Asli, Yildirir Aylin, Ozin Bulent, Muderrisoglu Haldun, Haberal Mehmet
Department of Cardiology, Baskent University Faculty of Medicine, Ankara, Turkey.
Exp Clin Transplant. 2010 Jun;8(2):142-5.
The potential for perioperative and late cardiovascular complications in liver transplant candidates makes careful preoperative risk assessment imperative. We sought to identify the determinants of coronary artery disease in liver transplant candidates.
Liver transplant candidates with end-stage liver disease who were more than 40 years old and undergoing coronary angiography were retrospectively included in this study. Patients with known coronary heart disease or valvular heart disease were excluded. Symptoms, coronary artery disease risk factors, blood tests, electrocardiogram, echocardiography, treadmill stress test, myocardial perfusion scintigraphy, and coronary angiography results were recorded. A multivariable logistic regression model was used to assess the independent predictors of coronary artery disease.
A total of 139 patients (mean age, 52 +/- 8; 110 male [79%]) were included in the analysis. Coronary angiography revealed that 13 patients (9.4%) had coronary artery disease. The frequency of diabetes mellitus, stable angina symptoms, positive smoking status, presence of 2 or more risk factors for coronary artery disease, and mean low-density lipoprotein cholesterol levels were significantly higher in patients with coronary artery disease than in patients without coronary artery disease. The electrocardiogram, echocardiography, and noninvasive stress test results were not valuable tools in liver transplant candidates for the diagnosis of coronary artery disease. In multivariate analysis, typical angina symptoms and low-density lipoproteins cholesterol levels appeared to be independent factors that were predictive of coronary artery disease.
Typical anginal symptoms and low-density lipoprotein cholesterol levels seem to be the best predictors of coronary artery disease in liver transplant candidates.
肝移植候选者围手术期及晚期心血管并发症的可能性使得术前进行仔细的风险评估势在必行。我们试图确定肝移植候选者冠状动脉疾病的决定因素。
本研究回顾性纳入了年龄超过40岁且正在接受冠状动脉造影的终末期肝病肝移植候选者。已知患有冠心病或瓣膜性心脏病的患者被排除。记录症状、冠状动脉疾病危险因素、血液检查、心电图、超声心动图、平板运动试验、心肌灌注显像及冠状动脉造影结果。采用多变量逻辑回归模型评估冠状动脉疾病的独立预测因素。
共有139例患者（平均年龄52±8岁；男性110例[79%]）纳入分析。冠状动脉造影显示13例患者（9.4%）患有冠状动脉疾病。患有冠状动脉疾病的患者中糖尿病、稳定型心绞痛症状、吸烟阳性、存在2个或更多冠状动脉疾病危险因素以及平均低密度脂蛋白胆固醇水平的发生率显著高于无冠状动脉疾病的患者。心电图、超声心动图及无创应激试验结果对肝移植候选者诊断冠状动脉疾病并非有价值的工具。多变量分析中，典型心绞痛症状及低密度脂蛋白胆固醇水平似乎是冠状动脉疾病的独立预测因素。
典型心绞痛症状及低密度脂蛋白胆固醇水平似乎是肝移植候选者冠状动脉疾病的最佳预测因素。
