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

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

doi:10.12659/AOT.934163

Journal article

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

Cerise Kleb, Vardhmaan Jain, Chirag Sheth, Kathy Wolski, Samir Kapadia, Richard Grimm, Milind Desai, Amar Krishnaswamy, Nicholas Kassis, Calvin Sheng, …

Annals of transplantation, Vol.26, pp.e934163-e934163-9

12/22/2021

DOI: 10.12659/AOT.934163

PMCID: PMC8711211

PMID: 34934037

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Abstract

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; P<0.001). 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.

Calcium

Coronary Artery Disease - diagnostic imaging

Dobutamine

Echocardiography, Stress

Humans

Liver Transplantation

Sensitivity and Specificity

Details

Title: Subtitle: Comparison of Coronary Artery Calcium Scoring with Dobutamine Stress Echo for Detection of Coronary Artery Disease Before Liver Transplantation
Creators: Cerise Kleb - Cleveland Clinic
Vardhmaan Jain - Cleveland Clinic
Chirag Sheth - Department of Internal Medicine, Sutter Tracy Community Hospital, Tracy, CA, USA
Kathy Wolski - Cleveland Clinic
Samir Kapadia - Cleveland Clinic
Richard Grimm - Cleveland Clinic
Milind Desai - Cleveland Clinic
Amar Krishnaswamy - Cleveland Clinic
Nicholas Kassis - Cleveland Clinic
Calvin Sheng - Cleveland Clinic
Huili Zheng - National University Heart Centre Singapore
Jacek Cywinski - Cleveland Clinic
K V Narayanan Menon - Cleveland Clinic
Bijan Eghtesad - Cleveland Clinic
Teresa Diago Uso - Cleveland Clinic
Cristiano Quintini - Cleveland Clinic
Paul Schoenhagen - Cleveland Clinic
Serge C Harb - Cleveland Clinic
Vikram Sharma - University of Iowa
Maan Fares - Cleveland Clinic
Resource Type: Journal article
Publication Details: Annals of transplantation, Vol.26, pp.e934163-e934163-9
DOI: 10.12659/AOT.934163
PMID: 34934037
PMCID: PMC8711211
NLM abbreviation: Ann Transplant
ISSN: 2329-0358
eISSN: 2329-0358
Language: English
Date published: 12/22/2021
Academic Unit: Internal Medicine
Record Identifier: 9984806500902771

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