{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T15:30:06Z","timestamp":1791559806374,"version":"4.3.4"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2020,5,17]],"date-time":"2020-05-17T00:00:00Z","timestamp":1589673600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2020,5,17]],"date-time":"2020-05-17T00:00:00Z","timestamp":1589673600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Hepatology"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n            <jats:title>Background and Aims<\/jats:title>\n            <jats:p>A study at Indiana University demonstrated a reduction in myocardial infarction (MI) incidence with increased frequency of cardiac catheterization (CATH) in liver transplant (LT) candidates. A strict protocol for performing CATH based upon predefined risk factors, rather than noninvasive testing alone, was applied to a subgroup (2009\u20102010) from that study. CATH was followed by percutaneous coronary intervention (PCI) in cases of significant coronary artery disease (CAD; \u226550% stenosis). The current study applies this screening protocol to a larger cohort (2010\u20102016) to assess post\u2010LT clinical outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Approach and Results<\/jats:title>\n            <jats:p>Among 811 LT patients, 766 underwent stress testing (94%) and 559 underwent CATH (69%), of whom 10% had CAD requiring PCI. The sensitivity of stress echocardiography in detecting significant CAD was 37%. Predictors of PCI included increasing age, male gender, and personal history of CAD (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.05 for all). Compared to patients who had no CATH, patients who underwent CATH had higher mortality (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.07), and\u00a0the hazard rates (HR) for mortality increased with CAD severity (normal CATH, HR, 1.35; 95% confidence interval [CI], 0.79\u20102.33; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.298; nonobstructive CAD, HR, 1.53; 95% CI, 0.84\u20102.77; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.161; and significant CAD, HR, 1.96; 95% CI, 0.93\u20104.15; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.080).\u00a0Post\u2010LT outcomes were compared to the 2009\u20102010 subgroup from the previous study and showed similar 1\u2010year overall mortality (8% and 6%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.48), 1\u2010year MI incidence (&lt;1% and &lt;1%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.8), and MI deaths as a portion of all deaths (3% and 9%, <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.35).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Stress echocardiography alone is not reliable in screening LT patients for CAD. Aggressive CAD screening with CATH is associated with low rate of MI and cardiac mortality and validates the previously published protocol when extrapolated over a larger sample and longer follow\u2010up period.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.31023","type":"journal-article","created":{"date-parts":[[2019,11,7]],"date-time":"2019-11-07T12:54:15Z","timestamp":1573131255000},"page":"240-256","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":45,"title":["Pre\u2013Liver Transplant Cardiac Catheterization Is Associated With Low Rate of Myocardial Infarction and Cardiac Mortality"],"prefix":"10.1097","volume":"72","author":[{"given":"Issa","family":"Kutkut","sequence":"first","affiliation":[{"name":"Division of Cardiology,New York\u2010Presbyterian Brooklyn Methodist Hospital,Brooklyn,NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rayan Jo","family":"Rachwan","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lava R.","family":"Timsina","sequence":"additional","affiliation":[{"name":"Department of Surgery,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan S.","family":"Ghabril","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco A.","family":"Lacerda","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology,Department of Internal Medicine,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4043-2943","authenticated-orcid":false,"given":"Chandrashekhar A.","family":"Kubal","sequence":"additional","affiliation":[{"name":"Department of Transplantation Surgery,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick D.","family":"Bourdillon","sequence":"additional","affiliation":[{"name":"Division of Cardiology,Department of Internal Medicine,Indiana University School of Medicine,Indianapolis,IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard S.","family":"Mangus","sequence":"additional","affiliation":[{"name":"Department of Transplantation Surgery,Indiana University School of 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