Trends, Clinical Characteristics, and Outcomes of Percutaneous Coronary Intervention in Liver Transplant Recipients

IF 1.9 4区医学 Q2 SURGERY

Clinical Transplantation Pub Date : 2025-05-15 DOI:10.1111/ctr.70181

Song Peng Ang, Jia Ee Chia, Jose Iglesias, Chayakrit Krittanawong

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引用次数: 0

Abstract

Background

Coronary artery disease (CAD) poses a significant challenge for liver transplant recipients (LTRs) who face higher cardiovascular risks due to immunosuppressive therapies and metabolic changes. While extensive research has focused on CAD management in patients awaiting liver transplantation, data on the outcomes of percutaneous coronary intervention (PCI) in the post-transplant population remain limited.

Methods

This retrospective cohort study used the National Inpatient Sample database (2016–2021) to evaluate PCI hospitalizations involving LTR and non-transplant patients. Propensity score matching (1:3) was applied to balance the covariates between the LTRs and non-transplant patients. The primary outcome was in-hospital mortality.

Results

Among the 2 681 545 PCI hospitalizations, LTRs accounted for 0.1% (n = 2675). LTRs were more likely to have diabetes (60.56% vs. 41.36%) and chronic kidney disease (60.93% vs. 21.06%) but less likely to have hyperlipidemia (58.32% vs. 72.65%; all p < 0.001). The crude rates of AKI (32.34% vs. 16.07%; p < 0.001) and blood transfusion (5.61% vs. 2.76%; p = 0.0001) were higher in the LTRs. After matching, the LTRs were associated with lower odds of in-hospital mortality (OR, 0.55; 95% CI, 0.30–1.00; p = 0.05) and cardiogenic shock (OR, 0.46; 95% CI, 0.29–0.74; p = 0.001). PCI hospitalizations among LTRs increased over time, peaking in 2019 (116.6/100 000).

Conclusion

Despite higher comorbidities and complication rates, LTRs undergoing PCI exhibited lower in-hospital mortality than non-transplant patients, likely reflecting survivor bias, rigorous pre- and post-transplant care, and specialized management. These preliminary findings highlight the need for further studies with detailed clinical data to validate the current findings.

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肝移植受者经皮冠状动脉介入治疗的趋势、临床特点和结果

背景冠状动脉疾病（CAD）对肝移植受者（LTRs）提出了重大挑战，他们由于免疫抑制治疗和代谢改变而面临更高的心血管风险。虽然广泛的研究集中在等待肝移植患者的CAD管理上，但关于经皮冠状动脉介入治疗（PCI）在移植后人群中的结果的数据仍然有限。方法本回顾性队列研究使用国家住院患者样本数据库（2016-2021）评估LTR和非移植患者的PCI住院情况。采用倾向评分匹配（1:3）来平衡ltr和非移植患者之间的协变量。主要终点是住院死亡率。结果2 681 545例PCI住院患者中，ltr占0.1% （n = 2675）。ltr更易患糖尿病（60.56% vs. 41.36%）和慢性肾脏疾病（60.93% vs. 21.06%），但更易患高脂血症(58.32% vs. 72.65%；所有p <；0.001)。AKI粗发生率(32.34% vs. 16.07%；p & lt;0.001)和输血(5.61% vs. 2.76%；p = 0.0001)。匹配后，ltr与较低的院内死亡率相关(OR, 0.55；95% ci, 0.30-1.00；p = 0.05)和心源性休克(OR, 0.46；95% ci, 0.29-0.74；p = 0.001)。ltr的PCI住院率随着时间的推移而增加，在2019年达到峰值（116.6/10万）。结论：尽管合并症和并发症发生率较高，但接受PCI的ltr患者的住院死亡率低于未接受移植的患者，这可能反映了幸存者偏见、严格的移植前和移植后护理以及专门的管理。这些初步发现强调需要进一步的研究和详细的临床数据来验证目前的发现。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Transplantation 医学-外科

CiteScore

3.70

自引率

4.80%

发文量

286

审稿时长

2 months

期刊介绍： Clinical Transplantation: The Journal of Clinical and Translational Research aims to serve as a channel of rapid communication for all those involved in the care of patients who require, or have had, organ or tissue transplants, including: kidney, intestine, liver, pancreas, islets, heart, heart valves, lung, bone marrow, cornea, skin, bone, and cartilage, viable or stored. Published monthly, Clinical Transplantation’s scope is focused on the complete spectrum of present transplant therapies, as well as also those that are experimental or may become possible in future. Topics include: Immunology and immunosuppression; Patient preparation; Social, ethical, and psychological issues; Complications, short- and long-term results; Artificial organs; Donation and preservation of organ and tissue; Translational studies; Advances in tissue typing; Updates on transplant pathology;. Clinical and translational studies are particularly welcome, as well as focused reviews. Full-length papers and short communications are invited. Clinical reviews are encouraged, as well as seminal papers in basic science which might lead to immediate clinical application. Prominence is regularly given to the results of cooperative surveys conducted by the organ and tissue transplant registries. Clinical Transplantation: The Journal of Clinical and Translational Research is essential reading for clinicians and researchers in the diverse field of transplantation: surgeons; clinical immunologists; cryobiologists; hematologists; gastroenterologists; hepatologists; pulmonologists; nephrologists; cardiologists; and endocrinologists. It will also be of interest to sociologists, psychologists, research workers, and to all health professionals whose combined efforts will improve the prognosis of transplant recipients.