Pretransplant coronary artery disease is a predictor for myocardial infarction and cardiac death after liver transplantation

Background: Cardiovascular disease is a serious problem of liver transplant (LT) recipients because of increased cardiovascular risk due to immunosuppressive therapy, higher age, intraoperative risk and comorbidities (such as diabetes and nicotine abuse). Reported frequency of cardiovascular events after LT shows a high variability between different LT cohorts. Our aim was to analyze a cohort of LT recipients from a single center in Germany to evaluate frequency of the cardiovascular endpoints (CVE) myocardial infarction and/or cardiac death after LT and to investigate correlations of CVE post LT with pretransplant patient characteristics. Patients: In total, data from 352 LT patients were analyzed. Patients were identified from an administrative transplant database, and all data were retrieved from patients' charts and reports. Results: During the median follow-up of 4.0 (0 - 13) years, 10 cases of CVE were documented (six myocardial infarctions and four coronary deaths). The frequency of CVE did not differ according to classic cardiovascular risk factors such as body mass index (p = 0.071), total cholesterol (p = 0.533), hypertension (p = 0.747), smoking (p = 1.000) and pretransplant diabetes mellitus (p = 0.146). In patients with pretransplant coronary heart disease (n = 24; 6.8%) CVE were found more frequently (p = 0.024). Conclusion: In summary, we found a rate of 2.8% CVE after LT in a German transplant cohort. Pretransplant CHD was the only risk factor for CVE, but showed no significant impact on overall survival.