Abstract 1330: Prognostic Markers of Long Term Cardiac Outcomes Among Patients Undergoing Liver Transplant Surgery
Background: Long term cardiac outcomes of liver transplant surgery (LTS) patients are unknown. We hypothesized a higher risk of adverse cardiac outcomes in this population undergoing LTS compared to other non-cardiac surgeries.
Methods: Patients who had LTS between 2001–2005 were studied. The three outcomes were presence of myocardial infarction (MI), death or either outcome over a follow up period of 1.2±0.7 years following LTS. Logistic regression analysis was used to identify univariate/multivariate predictors for cardiac outcomes. Salient variables of clinical demographics, cardiac medications, stress echo variables, EKG findings, and postoperative complications were included in the analysis.
Results: Of 413 patients (mean age 52±9 years, 67% male), 106 (26%) were diabetic, 84 (20%) hypertensive and 173 (42%) had history of smoking. Of these, 27 (6.5%) experienced at least one MI and 50 (12%) died. Within the MI group, 25 (93%) had it within the first 30 days after LTS, and of those who died, 38 (76%) died within the first 30 days. 60 pts (15%) experienced an event which was defined as having either an MI or experiencing death. Multivariate predictors for outcomes are shown in the table⇓.
Conclusion: The long term adverse cardiac outcomes among patients undergoing LTS is high (15%) in our intermediate risk cohort. Important long term predictors include history of coronary disease, stroke and hypertension while preoperative catheterization and perioperative beta blocker use appear to be protective.