Revised Cardiac Risk Index can predict complications for liver transplant patients

SAN DIEGO — The Revised Cardiac Risk Index for liver transplant patients can identify those at increased risk for certain cardiovascular complications following the procedure, according to data presented at the 2012 Digestive Disease Week Annual Meeting.

Researchers evaluated 401 liver transplant patients from January 2000 to June 2008 with a median follow-up of 5.3 years. Four cardiovascular risk scores — Revised Cardiac Risk Index (RCRI), Dobutamine Stress Echo (DSE), Framingham Risk Score (FRS) and Adult Treatment Panel III (ATP III) — were collected from patients before transplant in order to determine each score’s ability to predict major adverse cardiac events among liver transplant recipients. Events incorporated into the study included acute coronary syndrome, coronary artery disease, cerebrovascular accident, percutaneous coronary intervention, coronary artery bypass graft, cardiac arrest and death.

Participants experienced 38 major cardiac events (9.5% of patients). Of the four evaluated risk scores, RCRI was found to be significantly predictive of major events following liver transplant (P=.01), with receiver operation characteristics analysis revealing an area under the curve of 0.807 (0.608, 1.000) for coronary artery disease and of 0.783 for coronary artery bypass graft (0.622, 0.944). Investigators also found that an RCRI score of more than 3 predicted coronary artery disease with 93.4% specificity and coronary artery bypass graft with 93.1% specificity.

“Cardiac complications are common, with approximately 10% of [liver transplant] patients experiencing a major adverse cardiac event,” researcher Mazen Albeldawi, MD, told Healio.com. “Those patients who have a history of cerebrovascular disease or coronary artery disease are at increased risk for developing cardiovascular outcomes post-transplant.”

For more information:

Albeldawi M. #Mo1940: Predicting Cardiovascular Complications After Liver Transplantation: A Role for Pretransplant Cardiovascular Risk Scores. Presented at: the 2012 Digestive Disease Week Annual Meeting; May 19-22, San Diego.