Abstract 599: Cardiovascular Risk Factors and Cardiovascular Events in Patients Undergoing Liver Transplantation

Introduction: Patients undergoing liver transplantation often have cardiovascular risk factors and may experience cardiovascular morbidity and mortality. Understanding the role of risk factors and the benefit of treatment is important for the careful selection of liver transplantation candidates to minimize post-transplant cardiac morbidity. We investigated the prevalence of cardiovascular risk factors and their association with cardiovascular events in liver transplantation patients. Methods: We studied 182 consecutive patients undergoing liver transplantation in our center between 1997 and 2011 to evaluate factors associated with new cardiovascular events after liver transplantation. Results: The cohort consisted of 179 men and 3 women with a mean age of 58.8 ± 6.2 years, model for end-stage liver disease (MELD) score of 17.4 ±7 at initial evaluation, and Framingham risk score of 9.0 ±5.1. In this cohort 15 ( 8.2%) patients were smokers, 48 (26.4%) had hypertension, 47 (25.8%) had diabetes mellitus, 35 (19.2%) had coronary artery disease, and 27 (14.8%) had dyslipidemia prior to their transplant surgery. After a median follow-up of 5.6 years, a total of 52 (28.6%) patients died and 6 (3.3%) died of cardiac causes. New coronary events and/or revascularization procedures post-transplant occurred in 22 (12%) patients. The pre-transplant variable associated with post-transplant cardiac events and/or revascularization was smoking status at the time of evaluation (P=0.01). Post-transplant factors associated with cardiac events included use of beta-blockers (P=0.01) or statins (P=0.01). Conclusion: Although cardiovascular risk factors and coronary disease are very common, cardiovascular events are relatively infrequent in patients undergoing liver transplantation. Smoking at time of transplant evaluation and post-transplant medical therapy with beta-blockers and statins are significantly associated with the occurrence of post-transplant cardiac events including revascularization.