Long-Term Survival in Liver Transplant Patients With Coronary Artery Disease

作者：Christopher Wray, Jennifer Scovotti, Jonathan M. Tobis, Henry M. Honda, Raymond M. Planinsic, Ann Walia, James Y. Findlay, Gebhard Wagener, Jacek B. Cywiński, Andrea Olmos, Daniela Markovic, Christopher Hughes, Abhinav Humar, Rigoberto Sierra-Anderson, Douglas G. Farmer, Danny Q Le, Randolph H. Steadman · 发表于：JACC Advances · 年份：2025 · DOI：10.1016/j.jacadv.2025.102299 · 被引用次数：2 · 研究领域：Organ Transplantation Techniques and Outcomes、Liver Disease and Transplantation、Renal Transplantation Outcomes and Treatments

BACKGROUND: The age of liver transplant (LT) recipients continues to increase, and as a result, the prevalence of coronary artery disease (CAD) has risen. Long-term post-transplant outcomes in LT patients with CAD are poorly understood. OBJECTIVES: We previously demonstrated in a multi-institutional LT cohort that early post-transplant survival was similar between recipients with angiographically-proven, treated CAD and those with no CAD and nonobstructive CAD. We now present a follow-up study in this same cohort. Our objective is to determine long-term post-transplant survival in LT recipients with known pretransplant CAD. All-cause mortality is the primary outcome. METHODS: We performed a retrospective analysis for post-transplant survival in 604 adult LT recipients who underwent angiography prior to LT at 7 institutions between 1998 and 2010. RESULTS: Angiographically-proven obstructive CAD (≥50% stenosis) was present in 145 of 604 patients (24%). No CAD or nonobstructive CAD was found in 459 patients (76%). Mortality was higher in patients with CAD (adjusted HR: 1.39; CI: 1.06-1.82; P = 0.0159) than in those without CAD. Patients with CAD were further stratified by CAD severity and by pretransplant coronary revascularization. Mortality was higher in patients with severe CAD as defined by >70% vessel stenosis (adjusted HR: 1.63; CI: 1.19-2.22; P = 0.002) and in patients that underwent revascularization (adjusted HR: 1.62; 95% CI: 1.18-2.23, P = 0.003) than in those without...