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- W2050544044 abstract "Purpose: Up to 50% of deaths in the perioperative period of liver transplantation are attributed to cardiovascular events. The existence of cardiovascular disease increases the perioperative risk and mortality in the first month post-transplant. There is no specific score validated for preoperative liver transplantation evaluation, nor clinical predictors that identify those patients who need thorough assessment and care. The aim of this study is to identify predictors of the presence of heart disease among patients evaluated for liver transplantation. Methods: 453 outpatients consecutively evaluated in the waiting list for liver transplantation underwent a cardiological assessment protocol that included: history and physical examination, estimation of functional capacity, electrocardiography, chest radiography and echocardiography. Myocardial perfusion scintigraphy, dobutamine stress echocardiography or coronary angiography were performed in patients with moderated or high likelihood of coronary disease. The severity of cirrhosis was estimated by MELD score (Model for End-Stage Liver Disease), which is calculated from laboratory tests (prothrombin time, bilirubin and creatinine). Statistical analysis: Continuous variables were presented as mean and standard deviation or median. Categorical variables were presented as proportions and/or percentages. Continuous variables were compared with the Mann-Whitney test and categorical variables with the chi-square test. The p value <0.05 was considered statistically significant. To find predictors of heart disease, we used simple linear regression and multiple regression. We used the statistical package SPSS 18.0. Results: 60 (13.2%) patients were diagnosed with heart disease. In the population with cardiovascular disease, 6.6% had coronary artery disease, 5.0% valvular heart disease, 4.0% heart failure with systolic dysfunction and 1.0% sustained arrhythmias. High blood pressure (HBP), chronic kidney disease (CKD) and poor functional capacity (FC) were more common in patients with heart disease (P <0.05). In simple linear regression, the following parameters were predictors of cardiopathy: HBP: odds ratio (OR)=3.05 (confidence interval (CI)=1.4 to 4.4) p = 0.002; CKD: OR=3.05 (CI=1.27 - 7.32) p = 0.01; MELD score ≥ 24: OR = 3.2 (CI 1.08 to 10.0) p = 0.03. In multiple logistic regression, only HBP (OR = 4.0) and MELD score≥ 24 (OR = 3.9) remained as predictors of heart disease. Conclusion: High blood pressure and severe liver disease with MELD score ≥ 24 are predictors of the presence of heart disease in patients evaluated for liver transplantation." @default.
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- W2050544044 date "2013-08-02" @default.
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- W2050544044 title "Clinical predictors of primary cardiopathies in liver transplantation candidates" @default.
- W2050544044 doi "https://doi.org/10.1093/eurheartj/eht308.p1558" @default.
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