Coronary Atherosclerosis in Liver Transplant Recipients and Population Controls: A Nationwide Study Using...

Area of Science:

• Cardiology
• Transplant Hepatology
• Radiology

Background:

• Coronary atherosclerosis prevalence and severity in liver transplant (LTx) recipients are not well-understood due to reliance on limited imaging data.
• Prior studies often used clinically indicated or retrospective imaging, lacking standardized research protocols.

Purpose of the Study:

• To investigate the prevalence and severity of coronary atherosclerosis in LTx recipients.
• To compare coronary atherosclerosis in LTx recipients versus matched control subjects using standardized coronary CT angiography.

Main Methods:

• A cross-sectional study matched 205 LTx recipients (from the DACOLT study) with 1,025 population controls (from the Copenhagen General Population Study) by age and sex.
• Standardized questionnaires, physical examinations, and coronary CT angiography were performed.
• Coronary atherosclerosis was classified as any, obstructive (≥50% stenosis), or extensive (>5 segments); logistic regressions adjusted for cardiovascular risk factors.

Main Results:

• LTx recipients exhibited higher prevalence of any (63% vs 46%), obstructive (18% vs 10%), and obstructive-extensive (13% vs 6%) coronary atherosclerosis compared to controls.
• After adjustment, LTx recipients had significantly increased odds for any (OR: 2.19), obstructive (OR: 2.73), and obstructive-extensive (OR: 3.90) coronary atherosclerosis.
• LTx recipients with coronary atherosclerosis were more likely to have high-risk plaque (OR: 2.10).

Conclusions:

• Liver transplant recipients demonstrate significantly higher prevalence and severity of coronary atherosclerosis than general population controls, even after accounting for traditional risk factors.
• Enhanced cardiovascular risk assessment and preventive measures are crucial for LTx recipients.
• Findings stem from the Danish Comorbidity in Liver Transplant Recipients Study (DACOLT; NCT04777032).