Related Experiment Video
Updated: Oct 27, 2025
Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Prognostic Value of Computed Tomographic Coronary Angiography for Long-Term Major Adverse Cardiac Events after Liver
Doo-Hwan Kim1, Young-Kug Kim1, Tae-Yong Ha2
1Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Korea.
Insights
Computed tomographic coronary angiography (CTCA) can predict long-term cardiac events after liver transplantation. A high coronary artery calcium score combined with obstructive coronary artery disease on CTCA is a significant risk factor for major adverse cardiac events (MACEs).
Area of Science:
- Cardiology
- Transplant Surgery
- Radiology
Background:
- Computed tomographic coronary angiography (CTCA) shows prognostic value for early major adverse cardiac events (MACEs) post-liver transplantation (LT).
- The association between CTCA findings and long-term MACEs in LT recipients is not well-established.
Purpose of the Study:
- To evaluate the association between CTCA and long-term MACEs within 5 years after living donor liver transplantation (LDLT).
- To identify predictors of long-term MACEs in LDLT recipients.
Main Methods:
- Analysis of 628 LDLT recipients who underwent CTCA between 2010 and 2012.
- Investigation of MACEs within 5 years post-LDLT.
- Application of Fine and Gray competing risk regression to identify associated factors.
Main Results:
- Only 7.6% of patients experienced MACEs within 5 years.
- A coronary artery calcium score (CACS) >400 combined with obstructive coronary artery disease (CAD) was significantly associated with MACEs (SHR: 5.01).
- Independent predictors of MACEs included age, diabetes mellitus, dyslipidemia, and creatinine levels.
Conclusions:
- Preoperative noninvasive CTCA, particularly when assessing coronary artery stenosis and CACS, is crucial for predicting long-term MACEs in LT recipients.
- The combination of CACS >400 and obstructive CAD on CTCA may serve as a prognostic indicator for MACEs within 5 years post-LDLT.
Abstract:
Computed tomographic coronary angiography (CTCA) has prognostic value for early major adverse cardiac events (MACEs) after liver transplantation. However, the association between CTCA and long-term MACEs in liver transplant (LT) recipients remains unknown. We evaluated the association between CTCA and long-term MACEs within 5 years after living donor liver transplantation (LDLT). A total of 628 LDLT recipients who underwent CTCA were analyzed between 2010 and 2012. MACEs were investigated within 5 years after LDLT. The factors associated with long-term MACEs in transplant recipients were evaluated. Only 48 (7.6%) patients developed MACEs. In the Fine and Gray competing risk regression, a coronary artery calcium score (CACS) of >400 combined with obstructive coronary artery disease (CAD) (subdistribution hazard ratio: 5.01, 95% confidence interval: 2.37-10.58, p < 0.001), age (1.05, 1.01-1.10, p = 0.018), diabetes mellitus (2.43, 1.37-4.29, p = 0.002), dyslipidemia (2.45, 1.23-4.70, p = 0.023), and creatinine (1.19, 1.08-1.30, p < 0.001) were independently associated with long-term MACEs. CACS (>400) combined with obstructive CAD may be associated with MACEs within 5 years after LDLT, suggesting the importance of preoperative noninvasive CTCA in LT recipients. The evaluation of coronary artery stenosis on CTCA combined with CACS may have a prognostic value for long-term MACEs in LT recipients.
More Related Videos
Related Concept Videos
01:28Imaging Studies for Cardiovascular System V: CT
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:30Acute Coronary Syndrome III: Diagnostic Studies