Abstract
Abstract 15563: Impact of Cardiovascular Events on Short and Long-Term Mortality Following Liver Transplantation
Circulation (New York, N.Y.), Vol.140(Suppl_1), A15563
11/19/2019
DOI: 10.1161/circ.140.suppl_1.15563
Abstract
IntroductionPresent-day patients undergoing liver transplantation are older and have a higher risk of peri-operative cardiovascular events. However,data on the exact burden and impact of cardiovascular events following liver transplantation is still limitedHypothesisWe aimed to study the frequency of adverse cardiovascular events as well as their contribution to mortality in the setting of liver transplantationMethodsThis is retrospective analysis of data from a prospectively recorded database of patients who underwent liver transplantation at Cleveland Clinic between 2008- Jan 2019. In total there were 1526 patients in the final analysisResultsTotal mortality was 19.9% over a mean follow-up of 4.56 ± 3.3 years following liver transplantation. 30-day mortality was 3.3%. Median patient age was 57. Post-transplant cardiovascular complications included stroke (4.4% cases), myocardial infarction (MI) (4.5%), acute heart failure (6.9%) and arrhythmia (17.4%). Cardiovascular events associated with the highest hazard for long term mortality included acute stroke with an adjusted hazard ratio (HR) of 2.02 (Confidence Interval, CI, 1.3-3.2, p=0.002), acute MI with an adjusted HR of 1.99 (CI 1.16-3.43, p=0.012) and post-transplant acute heart failure with adjusted HR of 1.79 (CI 1.24-2.6, p=0.002). The composite of MACE (MI/Stroke/Heart failure) was noted in 13.3% patients with adjusted HR of 2.58 (CI 1.9-3.6; p <0.001). Occurrence of MACE was also associated with significant odds for 30-day mortality (Odds ratio 5.13, CI 1.3-20.5, p=0.02). Presence of diabetes mellitus was strongly associated with occurrence of MACE (adjusted HR 2.011, CI 1.44-2.8; p<0.001)ConclusionsThere is a high burden of major adverse cardiovascular events following liver transplantation with significant impact on short and long-term mortality, specially in diabetic patients, highlighting the importance of careful cardiovascular optimization prior to transplantation.
Details
- Title: Subtitle
- Abstract 15563: Impact of Cardiovascular Events on Short and Long-Term Mortality Following Liver Transplantation
- Creators
- Vikram Sharma - Cleveland ClinicJacek Cywinski - Cleveland ClinicK V Menon - Cleveland ClinicJamak Modaresi Esfeh - Cleveland ClinicRavi Nair - Cleveland ClinicParth Parikh - Cleveland ClinicTeresa Diago - Cleveland ClinicBijan Eghtesad - Cleveland ClinicCristiano Quintini - Cleveland ClinicMaan Fares - Cleveland Clinic
- Resource Type
- Abstract
- Publication Details
- Circulation (New York, N.Y.), Vol.140(Suppl_1), A15563
- Publisher
- American Heart Association, Inc
- DOI
- 10.1161/circ.140.suppl_1.15563
- ISSN
- 0009-7322
- Language
- English
- Date published
- 11/19/2019
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984808214102771
Metrics
1 Record Views