The predictive value of coronary artery calcium detected by computed tomography in a prospective study on cardiac allograft vasculopathy in heart transplant patients
| Autor: | Thor Edvardsen, Leiv Sandvik, Einar Gude, Jarl Å. Jakobsen, Lars Aaberge, Andreas Abildgaard, Lars Gullestad, Anne Günther, Rune Andersen |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Computed tomography Coronary Artery Disease 030204 cardiovascular system & hematology Cardiac allograft vasculopathy 030218 nuclear medicine & medical imaging 03 medical and health sciences Postoperative Complications 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Humans Lung transplantation Prospective Studies cardiovascular diseases Vascular Calcification Prospective cohort study Aged Heart transplantation Transplantation medicine.diagnostic_test Proportional hazards model business.industry nutritional and metabolic diseases Middle Aged medicine.disease Coronary artery calcium Stenosis cardiovascular system Cardiology Heart Transplantation Female Tomography X-Ray Computed business |
| Zdroj: | Transplant International. 31:82-91 |
| ISSN: | 0934-0874 |
| DOI: | 10.1111/tri.13057 |
| Popis: | The predictive value of coronary artery calcium (CAC) in heart transplant (HTX) patients is not established. We explored if the absence of CAC on computed tomography (CT) could exclude moderate and severe cardiac allograft vasculopathy [CAV2-3 ; the International Society for Heart and Lung Transplantation (ISHLT) recommended nomenclature] and significant coronary artery stenosis (diameter reduction ≥50%) and predict long-term clinical outcomes. HTX recipients (n = 133) were prospectively included and underwent CT for CAC scoring and invasive coronary angiography (ICA) 7.8 ± 5.0 years after HTX. CAC was detected in 73 (55%) patients. The absence of CAC on CT had a negative predictive value of 97% for ISHLT CAV2-3 and 88% for significant stenosis on ICA. During 7.5 ± 2.6 years of follow-up after CAC CT (n = 127), there were 57 (45%) nonfatal major adverse cardiac events and 23 (18%) deaths or graft losses registered as first events. Patients with CAC had significantly more events (P = 0.011). In an adjusted Cox regression analysis, the presence of CAC was significantly associated with a negative outcome (HR 1.8, 95% CI 1.1-3.0; P = 0.023). The absence of CAC predicted low prevalences of ISHLT CAV2-3 and significant coronary artery stenosis in HTX patients. The presence of CACS was significantly associated with a worse long-term outcome. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Plný text