Risk Factors and Cardiovascular Events in Orthotopic Liver Transplantation

Authors

  • Asghar Ali Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Brian Mitchell Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Robert Donovan Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Sarmath S Patel Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Peter Danyi Department of Medicine Veterans’ Affairs Medical Center, Salem, VA, USA
  • Hochong Giles Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Le Kang Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Michael Fuchs Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Douglas Heuman Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA
  • Ion S Jovin Department of Medicine McGuire Veterans’ Affairs Medical Center, Richmond, VA; Department of Medicine Virginia Commonwealth University, Richmond, VA, USA

DOI:

https://doi.org/10.15403/jgld-4613

Keywords:

coronary artery disease, cardiovascular disease, risk factors, risk stratification, liver transplantation

Abstract

Background and Aims: Patients undergoing liver transplantation often have significant cardiovascular risk factors and may experience cardiac-related morbidity and mortality. The aim of this study was to assess the frequency of cardiovascular risk factors and outcomes in this population, and to identify factors predictive of post-transplant cardiac morbidity and mortality.

Methods: We studied 261 patients who underwent liver transplantation at a single Veterans’ Affairs Medical center between 1997 and 2015 to evaluate new cardiovascular events post-transplantation.

Results: The cohort consisted of 261 patients (253 men and 8 women) with a mean age of 58.3 (± 6.5 years), mean model for end-stage liver disease score of 18.0 (±7.2), and mean Framingham risk score of 8.1 (± 4.9). After a median follow-up of 82 months a total of 75 (28.7%) patients died, with 13 deaths (17.3%) attributed to a primary cardiovascular event and 9 (12%) deaths due to a coronary-specific event. Coronary events and/ or the need for revascularization post-transplant occurred in 24 (9.2%) patients. The strongest pre-transplant predictors of mortality were age (p=0.01), Framingham risk score (p=0.01), preexisting coronary artery disease (p=0.01), and preexisting dyslipidemia (p=0.01). The strongest post-transplant predictors of mortality were new-onset hypertension (p=0.01) and new-onset diabetes mellitus (p=0.03) post-transplant.

Conclusions: In this cohort of veterans, coronary artery disease was significantly associated with mortality in the post liver transplantation population; however, the majority of deaths after transplant were attributable to other causes.

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Published

2023-03-31

How to Cite

1.
Ali A, Mitchell B, Donovan R, Patel SS, Danyi P, Giles H, Kang L, Fuchs M, Heuman D, Jovin IS. Risk Factors and Cardiovascular Events in Orthotopic Liver Transplantation. JGLD [Internet]. 2023 Mar. 31 [cited 2025 Jun. 15];32(1):51-7. Available from: https://www.jgld.ro/jgld/index.php/jgld/article/view/4613

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Original Article