SHA 056. Prevalence and prognosis of congestive heart failure in Saudi patients admitted with acute coronary syndrome (from SPACE registry)

Background: The prevalence of coronary artery disease (CAD) in end stage liver disease (ESLD) being evaluated for orthotopic liver transplantation (OLT) is unclear based on variable definition used for CAD. Aim: The objective of this study to investigate the prevalence of abnormal stress myocardial perfusion SPECT (MPS) imaging, as a marker for CAD, among patients with ESLD who were referred for stress MPS imaging as a routine work up before OLT. Methods and materials: We reviewed data on 167 patients who were referred for MPS as a routine work up before OLT over last 2 years. All patients underwent evaluation for CAD risk factors (age, hypercholesterolemia, diabetes mellitus, hypertension, and smoking), and stress MPS per standard protocol. Results: The total number patients referred for stress MPS was 167 patients. 7 patients (4%) were excluded for being have nondiagnostic studies. 147 patients (92%) have normal but only 13 patients (8%) have abnormal MPS scans. Diabetes mellitus and male gender were the most independent risk factors for abnormal MPS with p-value of .046, and 0.26 respectively. There was no significant association between the abnormal result with hypertension, hypercholesterolemia, smoking, age or etiology of the liver disease. Conclusions: Based on our data the prevalence of abnormal MPS and LVEF in patients with ESLD is 8%. DM and male gender were the most independent predictor factors for abnormal MPS. True prevalence of CAD and usefulness of MPS in patients with ESLD can only be studied using a very large and randomized prospective study.