Pre-Existing Coronary Artery Disease in Lung Transplantat Recipients: Does It Impact Outcomes?
1Heart and Vascular Institute at Penn-Presbyterian Medical Center, Perelman School of Medicine at University of Pennsylvania, Philadelphia, PA
2Heart and Vascular Institute, University of Pittsburgh Medical Center, Pittsburgh, PA
3Orthopaedic and Arthritis Center for Outcomes Research, Brigham and Womens Hospital, Boston, MA.
Meeting: 2015 American Transplant Congress
Abstract number: B207
Keywords: Lung transplantation, Outcome
Session Information
Session Name: Poster Session B: Lung- All Topics
Session Type: Poster Session
Date: Sunday, May 3, 2015
Session Time: 5:30pm-6:30pm
Presentation Time: 5:30pm-6:30pm
Location: Exhibit Hall E
INTRODUCTION:In patients undergoing lung transplantation (LTx), the impact of pre-existing coronary artery disease (CAD) on long-term outcomes is not well understood. This study examines the outcomes of patients undergoing LTx with and without CAD.
METHODS: 655 consecutive patients that underwent LTx at a single center from 2008 thru 2012 were evaluated prospectively in a hospital based registry. All patients >45 years of age underwent pre-LTx catheterization per institutional protocol. Presence of CAD defined as prior CABG, stenting, myocardial infarction (MI) or stenosis >50% in major epicardial vessel.
RESULTS: Of the 655 patients, 158 (24%) were identified as having CAD. Demographics for with and without CAD are age(66.4 vs 58.1 years, p<0.001), female (19.6 vs 50.3%, p<0.001), median LAS score (41.56 vs 40.62, p=0.57), and double LTx (72.8 vs 89.2, p<0.001). In patients with CAD, 1.9% had prior MI, 13.9% had prior stenting, 46.2% had newly diagnosed stenosis >50%, and 30.4% had at prior CAD with residual stenosis of >50%. Forty-five patients underwent revascularization prior to LTx.
Figure 1a shows survival curves for patients with and without CAD. Figure 1b illustrates outcomes for patients that underwent revascularization were similar to those without CAD and worse outcomes for those without revascularization. 
CONCLUSIONS: There is a trend towards worse outcomes in patients with CAD undergoing LTx but outcomes are improved in those who received pre-operative revascularization with stents. Further randomized studies are necessary in this cohort to examine the impact of moderate coronary disease and revascularization on outcomes.
To cite this abstract in AMA style:
Khandhar S, Tefera L, Volz E, Selzer F, Kormos R, Bermudez C. Pre-Existing Coronary Artery Disease in Lung Transplantat Recipients: Does It Impact Outcomes? [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/pre-existing-coronary-artery-disease-in-lung-transplantat-recipients-does-it-impact-outcomes/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress