Role of Coronary Angiography in Pre–Liver Transplantation Cardiac Evaluation: Experience From an Asian Transplant Institution

Abstract Background Liver transplant (LT) patients with significant coronary artery disease (CAD) have poorer outcomes. Pre-LT coronary angiography (CA) is associated with significant complications in cirrhotic patients. Methods This study aimed to identify predictors of abnormal CA in pre-LT cardiac assessment and to develop a predictive model to reduce unnecessary CA. From January 2006 to June 2013, 122 patients underwent CA based on the current institutional protocol. Results Forty-one (33.6%) patients had abnormal CA. Univariate analysis showed age ≥65 years ( P  = .001), cryptogenic cirrhosis ( P  = .046), cardiac comorbidities ( P  = .027), ischemic heart disease (IHD; P  = .002), left ventricular hypertrophy (LVH; P  = .004), hypertension ( P  = .002), diabetes mellitus ( P  = .017), dyslipidemia ( P P  = .003), ≥2 CAD risk factors ( P  = .001), and high Framingham risk score (hard CAD risk, P  = .018; cardiovascular disease: lipids, P  = .002; body mass index, P Conclusions Diabetes, dyslipidemia, IHD, age ≥65 years, and LVH appear to be predictors of abnormal CA in pre-LT patients. Our predictive model may help to better select patients for CA, although further validation is required.