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Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation
08:39

Reduced Complications after Arterial Reconnection in a Rat Model of Orthotopic Liver Transplantation

Published on: November 7, 2020

Coronary artery disease and its risk factors in patients presenting for liver transplantation

Edward Gologorsky1, Ernesto A Pretto2, Kyota Fukazawa2

  • 1Division of Cardiothoracic Anesthesiology, Department of Anesthesiology, Preoperative and Pain Management, University of Miami, Leonard Miller School of Medicine and Jackson Memorial Hospital, Miami, FL 33612, USA.

Journal of Clinical Anesthesia
|September 3, 2013
PubMed

Insights

Coronary artery disease (CAD) is most common in patients with hepatic steatosis, not alcoholic cirrhosis. CAD prevalence and risk factors in severe alcohol consumers mirror those with viral hepatitis.

Area of Science:

  • Cardiology
  • Hepatology
  • Transplantation Medicine

Background:

  • Coronary artery disease (CAD) is a significant concern in patients with end-stage liver disease (ESLD).
  • Understanding CAD prevalence across different ESLD etiologies is crucial for patient management and risk stratification.
  • The relationship between severe alcohol consumption and CAD in ESLD patients requires further clarification.

Purpose of the Study:

  • To investigate the distribution of coronary artery disease (CAD) and its risk factors among various etiologies of end-stage liver disease (ESLD).
  • To specifically examine the association between heavy alcohol consumption and CAD in the context of ESLD.

Main Methods:

  • A retrospective analysis of the National Standard Transplant Analysis and Research (STAR) file.
  • Inclusion of primary adult orthotopic liver transplant recipients from 2004-2006.
  • Categorization of patients into five groups based on ESLD etiology for comparative analysis of CAD prevalence and risk factors.

Main Results:

  • Out of 17,482 cases, coronary artery disease (CAD) incidence was highest in nonalcoholic hepatic steatosis (7.4%) and lowest in biliary cirrhosis (1.7%).
  • No significant difference in CAD prevalence or risk factors was observed between viral hepatitis (Hepatitis C 2.7%, Hepatitis B 2.3%) and alcoholic cirrhosis (2.9%).

Conclusions:

  • The prevalence of coronary artery disease (CAD) and its risk factors in patients with severe alcohol consumption are comparable to those with viral hepatitis.
  • Coronary artery disease (CAD) is most frequently observed in patients with hepatic steatosis.
  • This study challenges the assumption of reduced CAD expression and progression in alcoholic cirrhosis patients awaiting liver transplantation.
Abstract

Keywords:
Anesthesia preoperative assessmentCoronary artery diseaseLiver transplantation

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