Routine Coronary Angiography is Still the Key Test for Patients Eligible for Lung Transplantation Also for Those With No Symptoms and With High Risk of Coronary Artery Disease.

Autor: Karolak W; Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk, Gdańsk, Poland., Pastwa K; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Addo SA; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Khan S; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Shinde R; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Nuur IM; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Kumaravel A; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Reta FK; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Wojarski J; Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk, Gdańsk, Poland., Maruszewski M; Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk, Gdańsk, Poland., Woźniak-Grygiel E; Department of Histology, Institute of Medical Sciences, University of Opole, Opole, Poland., Chmielecki M; First Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland., Frankiewicz A; First Department of Cardiology, Medical University of Gdansk, Gdańsk, Poland., Nagajewski A; COVID Temporary Hospital, Szczytno County Hospital, Szczytno, Poland., Abba ME; Department of Pneumonology and Allergology, Medical University of Gdansk, Gdańsk, Poland., Łącka M; Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk, Gdańsk, Poland., Żeglen S; Department of Cardiac Surgery and Vascular Surgery, Medical University of Gdansk, Gdańsk, Poland; Department of Histology, Institute of Medical Sciences, University of Opole, Opole, Poland. Electronic address: slawomir.zeglen@gumed.edu.pl.
Jazyk: angličtina
Zdroj: Transplantation proceedings [Transplant Proc] 2022 May; Vol. 54 (4), pp. 1074-1077. Date of Electronic Publication: 2022 Apr 18.
DOI: 10.1016/j.transproceed.2022.02.049
Abstrakt: Background: Coronary artery disease (CAD) has a considerable morbidity and mortality effect on the outcomes of a lung transplant. Currently, coronary angiography is performed as part of the pretransplant evaluation process. Unfortunately, there are no clear guidelines about performing cardiac angiography in lung transplant candidates.
Background: The aim of our work is to find a correlation between cardiovascular risk and coronary arterial status to optimize the selection of patients for coronary angiography prior transplantation.
Methods: We retrospectively analyzed 48 patients in whom coronary angiography and cardiac catheterization was performed during assessment for bilateral lung transplantation at the Medical University of Gdańsk from 2018 to 2021. The coronary artery disease status was classified into 2 categories: without any stenosis and with stenosis. For each patient, the 10-year cardiovascular risk was estimated by using a Systematic COronary Risk Evaluation calculator modified for the Polish population.
Results: Coronary stenosis was detected in 15 patients during angiography (31%). The group with coronary stenosis had a median SCORE risk of 8%, which is considered as high risk, and in patients without stenosis it was 5%, which is also considered a high risk. Median mean pulmonary artery pressure in patients with stenosis was the same as that in patients without stenosis (23 mm Hg).
Conclusions: CAD among lung transplant candidates cannot be predicted by risk factors, so coronary angiography is very important as a part of the evaluation process. Because pulmonary hypertension has a big impact on surveillance after transplantation, performing heart catheterization during the qualification process is crucial.
(Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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