Cardiac Hemodynamic and Coronary Angiographic Characteristics of Patients Being Evaluated for Liver Transplantation

Tiukinhoy-Laing, Susan D.; Rossi, Joseph S.; Bayram, Melike; Luca, Leonardo De; Gafoor, Sameer; Blei, Andrés T.; Flamm, Steven L.; Davidson, Charles J.; Gheorghiade, Mihai

doi:10.1016/j.amjcard.2006.01.089

Cited by 183 publications

(132 citation statements)

References 7 publications

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“…[1][2][3][4] This association is perhaps best studied in nonalcoholic fatty liver disease (NAFLD), which is considered to be an independent risk factor for CVD. 5 NAFLD is characterized by the presence of hepatic steatosis in the absence of clinically significant alcohol use and is the most common cause of CLD.…”

mentioning

confidence: 99%

De novo hepatic steatosis drives atherogenic risk in liver transplantation recipients

Idowu¹,

Chhatrala²,

Siddiqui

et al. 2015

Liver Transpl

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Nonalcoholic fatty liver disease is associated with cardiovascular disease (CVD) in the general population. Despite a high prevalence of de novo hepatic steatosis after liver transplantation (LT), there are no data exploring the association between hepatic steatosis after LT and atherogenic risk. The aim of the study was to explore the impact of hepatic steatosis on serum atherogenic markers in liver transplantation recipients (LTRs). Biomarkers of CVD risk were compared in 89 LTRs with no known history of dyslipidemia, ischemic heart disease, or graft cirrhosis. To avoid potential confounders, LTRs on oral hypoglycemic agents, exogenous insulin, corticosteroids, or lipid‐lowering therapy were excluded. Only patients for whom histological assessment was available after LT were included in the study. Thirty‐five LTRs had de novo hepatic steatosis after LT, whereas 54 did not. Both cohorts were similar with regards to age, sex, ethnicity, and follow‐up from LT. Additionally, the traditional lipid profile was similar between the 2 cohorts. LTRs with hepatic steatosis had higher serum concentrations of small‐dense low‐density lipoprotein cholesterol (sdLDL‐C; 34.8 ± 16.9 versus 22.7 ± 11.2 mg/dL; P < 0.001), sdLDL‐C to low‐density lipoprotein cholesterol ratio (32.6 ± 11.6 versus 24.6 ± 10.2; P < 0.01), small‐dense low‐density lipoprotein particle concentration (sdLDL‐P; 770 ± 440 versus 486 ± 402 nmol/L; P < 0.01), very low density lipoprotein particle concentration (VLDL‐P; 7.90 ± 7.91 versus 3.86 ± 3.18 nmol/L; P < 0.01), and very low density lipoprotein size (VLDL‐size; 51.9 ± 6.4 versus 48.7 ± 6.3 nm; P = 0.06). LTRs with hepatic steatosis had higher serum insulin concentrations (27.8 ± 41.8 versus 11.7 ± 7.8 uU/mL; P < 0.01) but similar fasting glucose and hemoglobin A1c. Steatosis grade was directly related to sdLDL‐C, sdLDL‐P, insulin, VLDL‐P, and VLDL‐size. In multivariate analysis, the association between steatosis grade and sdLDL‐C (β = 0.03; P = 0.029), VLDL‐size (β = 0.316; P = 0.04), and low‐density lipoprotein particle size (β = –0.27; P = 0.05) was independent of sex, body mass index, age, diabetes mellitus, time from transplant, and indication for LT. In conclusion, de novo hepatic steatosis after LT is associated with atherogenic lipoproteins and independent of traditional CVD risk factors. Liver Transpl 21:1395‐1402, 2015. © 2015 AASLD.

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mentioning

confidence: 99%

De novo hepatic steatosis drives atherogenic risk in liver transplantation recipients

Idowu¹,

Chhatrala²,

Siddiqui

et al. 2015

Liver Transpl

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“…5,6 In contrast, the more recent literature reports a prevalence of CAD varying between 2.5% and 27.0% in patients who have cirrhosis being considered for liver transplantation (LT). [7][8][9][10] However, these studies differed in their definitions of CAD and in their diagnostic parameters, and the controls were inadequate, and they involved different individuals in terms of cardiac symptoms and history, as well. Reliable knowledge of the prevalence of occult CAD, particularly of anatomically confirmed CAD, in patients with LC is limited.…”

Section: Editorial See P 1337 Clinical Perspective On P 1362mentioning

confidence: 99%

Prevalence and Prediction of Coronary Artery Disease in Patients With Liver Cirrhosis

Shim

Kim

et al. 2014

Circulation

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Background-There is conflict regarding the prevalence of coronary artery disease (CAD) in patients with liver cirrhosis.This study aimed to investigate the prevalence of silent CAD in comparison with the general population, and to identify the relevant risk factors in patients with liver cirrhosis. Methods and Results-This retrospective study included 1045 prospectively registered consecutive patients with liver cirrhosis without any history of chest pain or CAD, who underwent computerized coronary angiography as a pretransplant workup. These were matched with 6283 controls with healthy livers, based on propensity scores according to established cardiovascular risk factors. Obstructive CAD was defined as ≥50% luminal narrowing in any artery. A matched analysis of 853 pairs showed that the proportion of subjects with obstructive CAD did not differ significantly between the cirrhotic and control groups (7.2% versus 7.9%, P=0.646), in agreement with the outcome of multivariate analysis for its predictors, with an adjusted odds ratio for liver cirrhosis of 1.06 (P=0.690). Nonobstructive CAD was more prevalent in the matched cirrhotic cases (30.6% versus 23.4%, P=0.001). In the pooled cirrhotic cohort, older age, male sex, hypertension, diabetes mellitus, and alcoholic cirrhosis were independently associated with obstructive CAD (adjusted odds ratios, 1.07, 2.74, 1.69, 2.37, and 2.17, respectively; P<0.05 for all), whereas liver function and coagulation parameters were not. Conclusions-Asymptomatic

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“…In 2006, TiukinhoyLaing et al 15 , also used coronary angiography as the gold standard in 161 patients aged 45 or older in the preoperative evaluation for liver transplantation. They found a high prevalence of risk factors for atherosclerosis, in which half of the patients had hypertension or diabetes and two or more risk factors besides age were found in a number greater than half.…”

Section: Godoy Et Al Obstructive Coronary Disease In Patients With Chmentioning

confidence: 99%

Doença coronária obstrutiva em hepatopatas crônicos que aguardam transplante hepático

Godoy

Roveri

Santos

et al. 2011

Arq. Bras. Cardiol.

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Cardiac Hemodynamic and Coronary Angiographic Characteristics of Patients Being Evaluated for Liver Transplantation

Cited by 183 publications

References 7 publications

De novo hepatic steatosis drives atherogenic risk in liver transplantation recipients

De novo hepatic steatosis drives atherogenic risk in liver transplantation recipients

Prevalence and Prediction of Coronary Artery Disease in Patients With Liver Cirrhosis

Doença coronária obstrutiva em hepatopatas crônicos que aguardam transplante hepático

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