Comparison of Coronary Artery Calcium Scoring with Dobutamine Stress Echo for Detection of Coronary Artery Disease Before Liver Transplantation

Autor:	Cerise Kleb, Vardhmaan Jain, Chirag Sheth, Kathy Wolski, Samir Kapadia, Richard Grimm, Milind Desai, Amar Krishnaswamy, Nicholas Kassis, Calvin Sheng, Huili Zheng, Jacek Cywinski, K.V. Narayanan Menon, Bijan Eghtesad, Teresa Diago Uso, Cristiano Quintini, Paul Schoenhagen, Serge C. Harb, Vikram Sharma, Maan Fares
Jazyk:	angličtina
Rok vydání:	2021
Předmět:	Transplantation Original Paper nutritional and metabolic diseases General Medicine Coronary Artery Disease Coronary Vessels Sensitivity and Specificity Liver Transplantation Dobutamine population characteristics Humans Calcium cardiovascular diseases Echocardiography Stress
Zdroj:	Annals of Transplantation
ISSN:	2329-0358 1425-9524
Popis:	BACKGROUND Dobutamine stress echocardiography (DSE) is commonly used for cardiovascular assessment before orthotopic liver transplantation (OLT). The coronary artery calcium score (CACS) is a useful screening tool for coronary artery disease (CAD). We aimed to compare the sensitivity and specificity of DSE and CACS for CAD in OLT candidates. MATERIAL AND METHODS A total of 265 of the 1589 patients who underwent OLT at our center between 2008 and 2019 had preoperative coronary angiography (CAG). Of these, 173 had DSE and 133 had a CT scan suitable for CACS calculation within 1 year of OLT. Patients with a nondiagnostic DSE were excluded (n=100). Two reviewers evaluated CACS on CT scans. The sensitivity/specificity of DSE and CACS for detection of angiographically significant CAD were calculated for patients with both tests (n=36). A separate analysis compared the sensitivity/specificity of a diagnostic DSE (n=73) and CACS (n=133) against CAG for all patients with either test. RESULTS Sensitivity and specificity were 57.1% and 89.7%, respectively, for DSE, compared with 71.4% and 62.1% for CACS at ≥100 Agatston score. For the analysis of all patients with either test, the sensitivity/specificity of DSE for detection of CAD and CACS were 30.8% and 85.0% and 80.0% and 62.8%, respectively. On ROC analysis, CACS was a satisfactory predictor of obstructive CAD (AUC, 0.76±0.06, 95% CI, 0.66-0.87; P0.001). CONCLUSIONS CACS may be an important tool for cardiovascular assessment in patients undergoing OLT. DSE was nondiagnostic in a large percentage of OLT candidates, limiting its use in this population.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_dedup___::fb48d7cb0f4d637b7005451e22ed002d http://europepmc.org/articles/PMC8711211 Zobrazit plný text záznamu