Abstract 11150: Preoperative Angiographically-Determined Coronary Artery Disease Provides Independent and Complementary Prediction for Atherothrombotic Events After Lung Transplantation
Background: Coronary angiography is routinely performed in lung transplant candidates. The objective of this study is to examine predictive value of pretransplant angiographically-determined coronary artery disease (CAD) for atherothrombotic events (AEs) after lung transplantation.
Methods: Consecutive isolated lung transplant recipients from 2008 to 2013 in our institution were identified. Significant CAD was defined as presence of ≥ 50% coronary stenosis in at least one artery or history of coronary revascularization. AEs were coronary events (revascularization, myocardial infarction), stroke/TIA, peripheral artery events (abdominal aortic aneurysm, limb ischemia, stenting).
Results: The study comprised of 280 patients with mean age of 60 ± 10 years. Sixty two percent were male. Primary lung pathologies were 29.6% obstructive, 1.8% vascular, 1.4% cystic fibrosis and 67.1% restrictive lung diseases. Prevalence of significant CAD was 17% (48/280). Median follow up was 2.1 years. AEs occurred in 5.7% (16/280) comprising of 25% (4/14) coronary events, 56% (9/16) stroke/TIA, 19% (3/16) peripheral artery events. Patients with significant CAD had higher annualized rate of AEs than those without (11.9% VS 0.6%; p<0.001) (fig 1A). Kaplan Meier analysis showed higher occurrence of AEs in significant CAD group (log-rank p < 0.001)(fig 1B). Significant CAD was an independent predictor for development of AEs (HR 13.50; 95%CI 3.66-49.75; p<0.001). Adding angiographic findings to cardiovascular risk factors gave incremental prognostic performance to the predictive model (chi square increased from 12.6 to 50.7; p<0.001).
Conclusion: Angiographically-determined CAD provides independent and complimentary prediction for AEs in lung transplantation. Our findings support important role of pretransplant coronary angiography since it could help identifying those whom earlier aggressive risk factor modification may be beneficial.
Author Disclosures: K. Chaikriangkrai: None. H.Y. Jhun: None. S. Jyothula: None.
- © 2014 by American Heart Association, Inc.