Impact of pre-operative coronary artery disease on cardiovascular events following lung transplantation

Kongkiat Chaikriangkrai, Soma Jyothula, Hye Yeon Jhun, Jerry Estep, Matthias Loebe, Scott Scheinin, Guillermo Torre-Amione

Research output: Contribution to journalArticle

9 Scopus citations

Abstract

Background This study examined the correlation between pre-operative coronary artery disease (CAD) and post-operative cardiovascular events in lung transplant recipients. Methods Consecutive isolated lung transplant recipients from 2007 to 2013 in our institution were identified and categorized as having significant CAD (≤ 50% coronary stenosis in at least 1 artery or history of coronary revascularization) or no-mild CAD. Patient records and death index data were analyzed for a median of 2 years for death or cardiovascular events, including coronary, cerebrovascular, and peripheral artery events. Results The study comprised 280 patients (62% male) with mean age of 60 ± 10 years. Cardiovascular events occurred in 5.7% (16 of 280) of the entire cohort. Patients with significant CAD had a higher annualized rate of cardiovascular events than those with no-mild CAD (11.9% vs 0.6%; p <0.001). Significant CAD was an independent predictor of cardiovascular events (hazard ratio, 20.32; 95% confidence interval, 5.79-71.26; p <0.001) but not all-cause mortality (log-rank p = 0.66). Adding significant CAD to clinical risk factors gave incremental prognostic performance compared with clinical risk factors alone (p <0.001 for increase in global chi-square). Conclusion Selected lung transplant candidates with significant CAD can undergo transplantation with equal mortality risk to those without CAD but are at a higher risk of non-fatal cardiovascular events. These data support the current practice of accepting a selected group of patients with CAD for lung transplantation and suggest that they should be monitored early and treated to prevent cardiovascular complications.

Original languageEnglish (US)
Pages (from-to)115-121
Number of pages7
JournalJournal of Heart and Lung Transplantation
Volume35
Issue number1
DOIs
StatePublished - Jan 1 2016
Externally publishedYes

Keywords

  • cardiovascular events
  • coronary artery disease
  • correlation
  • lung transplantation
  • mortality
  • preoperative
  • prognosis
  • stroke
  • survival

ASJC Scopus subject areas

  • Transplantation
  • Cardiology and Cardiovascular Medicine
  • Pulmonary and Respiratory Medicine
  • Surgery

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