Preoperative coronary calcium score is predictive of early postoperative cardiovascular complications in liver transplant recipients

Br J Anaesth. 2015 Mar;114(3):437-43. doi: 10.1093/bja/aeu384. Epub 2014 Nov 21.

Abstract

Background: Coronary computed tomographic angiography (coronary CT) is a non-invasive test for diagnosis of cardiac function. Coronary calcium scores determined by coronary CT are associated with cardiovascular risk factors. However, no studies have investigated the association between coronary calcium scores and cardiovascular complications after liver transplantation (LT). We therefore evaluated the utility of preoperative coronary calcium scores for predicting early postoperative cardiovascular complications in LT recipients.

Methods: Between 2010 and 2012, 443 LT recipients were analysed retrospectively. Preoperative cardiovascular assessments, including coronary CT, were performed. A coronary calcium score >400 was defined as a positive finding. Predictive factors of early postoperative cardiovascular complications were evaluated by univariate and multivariate analyses. Major cardiovascular complications occurring during a period of 1 month after LT were noted.

Results: Of the 443 patients, 38 (8.6%) experienced one or more cardiovascular complications. Positive coronary CT findings were seen in 11 (2.5%) patients. In the multivariate analysis, a coronary calcium score >400 {odds ratio (OR)=4.62 [95% confidence interval (CI): 1.14-18.72], P=0.032} and female sex [OR=2.76 (1.37-5.57), P=0.005] were predictive of cardiovascular complications.

Conclusions: A preoperative coronary calcium score of >400 predicted cardiovascular complications occurring 1 month after LT, suggesting that preoperative evaluation of coronary calcium scores could help predict early postoperative cardiovascular complications in LT recipients.

Keywords: coronary CT; early postoperative cardiovascular complications; liver transplantation.

Publication types

  • Observational Study

MeSH terms

  • Calcium / metabolism*
  • Cardiovascular Diseases / diagnostic imaging*
  • Cardiovascular Diseases / metabolism
  • Coronary Vessels / diagnostic imaging*
  • Coronary Vessels / metabolism*
  • Female
  • Humans
  • Liver Transplantation / methods*
  • Male
  • Middle Aged
  • Odds Ratio
  • Postoperative Complications / diagnostic imaging*
  • Postoperative Complications / metabolism
  • Predictive Value of Tests
  • Preoperative Period
  • Retrospective Studies
  • Risk Assessment / methods
  • Risk Assessment / statistics & numerical data
  • Risk Factors
  • Tomography, X-Ray Computed / methods
  • Transplant Recipients / statistics & numerical data*

Substances

  • Calcium