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dc.contributor.authorNayagam, JS
dc.contributor.authorNorton, BC
dc.contributor.authorBelete, S
dc.contributor.authorRosinhas, J
dc.contributor.authorRamos, K
dc.contributor.authorCramp, Matthew
dc.contributor.authorO'Kane, R
dc.contributor.authorCash, WJ
dc.contributor.authorMilan, Z
dc.contributor.authorNicholson, C
dc.contributor.authorMenon, K
dc.contributor.authorPrachalias, A
dc.contributor.authorSrinivasan, P
dc.contributor.authorAuzinger, G
dc.contributor.authorByrne, J
dc.contributor.authorMacCarthy, PA
dc.contributor.authorMelikian, N
dc.contributor.authorAgarwal, K
dc.contributor.authorAluvihare, VR
dc.contributor.authorJoshi, D
dc.contributor.authorHeneghan, MA
dc.date.accessioned2022-06-21T09:52:12Z
dc.date.available2022-06-21T09:52:12Z
dc.date.issued2022-07
dc.identifier.issn2666-9676
dc.identifier.other100100
dc.identifier.urihttp://hdl.handle.net/10026.1/19325
dc.description.abstract

Background Cardiovascular assessment is central to evaluation of liver transplant (LT) candidates. However, there is a lack of consensus on the diagnostic algorithm for screening for coronary artery disease (CAD), and the place for invasive coronary angiography (ICA) remains undefined. Methods We retrospectively analysed 1201 adults who underwent elective LT assessment over a 5-year period. For patients who underwent LT, survival data to 5 years post-LT was collected. Results ICA was performed in 259 (21.6%): 134 no CAD, 58 mild, 33 moderate, and 34 severe. Detection of CAD was associated with age (OR 1.08, P < 0.01), current smoking (OR 4.92, P < 0.01) and prior CAD (OR 8.93, P < 0.001). Poor performance on cardiopulmonary exercise test (CPET) was associated with age (OR 1.02, P < .05) and diabetes mellitus (OR 1.54, P < 0.05). 122 (10.2%) patients were declined due to severity of cardiovascular disease. 169/779 (21.7%) patients listed for LT had undergone ICA, and CAD was present in 73/169 (43.2%). The non-risk-adjusted all-cause post-LT 5-year survival was 82.6%, with no difference in survival in those with and without CAD on ICA. In patients with CAD, diabetes was associated with reduced survival (OR 3.78, P < 0.05). Conclusions Multi-modality cardiac evaluation is useful in high-risk patients undergoing LT assessment. ICA can be used with non-invasive assessments and risk factors to delineate candidacy. In selected patients with CAD, LT has been undertaken with comparable post-LT survival.

dc.format.extent100100-100100
dc.languageen
dc.language.isoen
dc.publisherElsevier BV
dc.subjectHeart Disease - Coronary Heart Disease
dc.subjectAtherosclerosis
dc.subjectHeart Disease
dc.subjectOrgan Transplantation
dc.subjectCardiovascular
dc.subjectTransplantation
dc.subjectClinical Research
dc.subjectDigestive Diseases
dc.subject4.2 Evaluation of markers and technologies
dc.subjectCardiovascular
dc.titleInvasive coronary angiography as a tool in cardiac evaluation for liver transplant candidates
dc.typejournal-article
plymouth.volume7
plymouth.publication-statusPublished
plymouth.journalJournal of Liver Transplantation
dc.identifier.doi10.1016/j.liver.2022.100100
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)
plymouth.organisational-group/Plymouth/Research Groups/Institute of Translational and Stratified Medicine (ITSMED)/CBR
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
dcterms.dateAccepted2022-05-15
dc.rights.embargodate2022-6-22
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1016/j.liver.2022.100100
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.typeJournal Article/Review


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