Cardiology
doi: 10.25005/2074-0581-2020-22-2-246-252
CORONARY ARTERY CALCIFICATION IN LIVER TRANSPLANT RECIPIENTS

E.A. Grigorenko1, N.P. Mitkovskaya1, V.V. Roudenok2, O.O. Rummo3

1Department of Cardiology and Internal Medicine, Belarusian State Medical University, Minsk, Republic of Belarus
2Department of Normal Anatomy, Belarusian State Medical University, Minsk, Republic of Belarus
3Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology, Minsk, Republic of Belarus

Objective: To study the dynamics of changes in the calcium index (CI) as a cardiovascular risk factor in patients with terminal liver diseases.

Methods: A prospective, single-center cohort study included 250 patients who needed liver transplantation. The duration of the follow-up period was 5.4±3.29 years from the moment of their inclusion on the waiting list. In addition to the assessment of prevalence and dynamics of traditional cardiovascular risk factors, indicators of the CI were determined by the method of multispiral computed tomography at the time of patients’ inclusion in the study and after 5 years of dynamic follow-up.

Results: The CI in patients with terminal liver diseases requiring transplantation was found to exceed the limits of the recommended norm determined by the 75th percentile in 152 (56.3%) subjects at the stage of their inclusion on the waiting list. Comparison of coronary calcification after 5 years of dynamic observation in liver transplant recipients revealed higher values of the CI compared with those in patients with terminal liver diseases who did not receive a donor organ (CI, AJ-130 – 223 (38; 597) and 141 (4; 176) units respectively, p<0.05; CI, Volume-130 – 314 (73; 748) and 203 (8; 284) mm2 respectively, p<0.01) as well as in patients with metabolic syndrome (CI, AJ-130 – 186 (78; 463) and 74 (21; 192) units respectively, p<0.01; CI, Volume-130 – 278 (74; 623) and 124 (74 ; 273) mm2 respectively, p<0.01) and/or coronary artery disease (CI, AJ-130 – 274 (102; 683) and 109 (34; 246) units respectively, p<0.01; CI, Volume-130 – 382 (98; 834) and 382 (98; 834) mm2 respectively, p<0.01) in the general population.

Conclusion: The results of the study indicate that in the long-term postoperative period, liver transplant recipients receiving immunosuppressive therapy, despite a radical solution to the problem of liver failure, developed coronary artery disease during five years of dynamic follow-up. In the study cohort, in the post-transplant period, there was an increase in the calcium index in comparison with the indicators obtained when patients were included in the waiting list, as well as in comparison with the value of the calcium index of patients with metabolic syndrome and coronary artery disease from the general population.

Keywords: Chronic liver diseases, terminal liver diseases, orthotopic liver transplantation, coronary atherosclerosis risk factors, coronary artery calcification, calcium index.

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Authors' information:

Grigorenko Elena Aleksandrovna
Candidate of Medical Sciences, Associate Professor, Professor of the Department of Cardiology and Internal Medicine, Belarusian State Medical University
Scopus ID: 57202152078
ORCID ID: 0000-0002-8120-6267
Author ID: 693698
SPIN: 2776-1433
E-mail: alegri@tut.by

Mitkovskaya Natalya Pavlovna
Doctor of Medical Sciences, Full Professor, Head of the Department of Cardiology and Internal Medicine, Belarusian State Medical University
Scopus ID: 6507367973
ORCID ID: 0000-0002-9088-721X
Author ID: 575103
SPIN: 6237-2736
E-mail: mitkovskaya1@mail.ru

Roudenok Vasili Vasilyevich
Doctor of Medical Sciences, Full Professor, Professor of the Department of Normal Anatomy, Belarusian State Medical University
Scopus ID: 6602342785
Author ID: 423310
SPIN: 7828-5202
E-mail: roudenok@bsmu.by

Rummo Oleg Olegovich
Corresponding Member of the National Academy of Sciences of Belarus, Doctor of Medical Sciences, Full Professor, Director, Minsk Scientific and Practical Center of Surgery, Transplantology and Hematology
Scopus ID: 6505579419
ORCID ID: 0000-0001-7023-4767
Author ID: 944080
SPIN: 5284-2260
E-mail: olegrumm@tut.by

Information about support in the form of grants, equipment, medications

The work was carried out with the support of the grant of the President of the Republic of Belarus for 2020 for the development and implementation of new organizational forms of work in practical health care aimed at improving the dispensary observation of liver and kidney transplant recipients in order to increase the effectiveness of primary and secondary prevention of cardiovascular complications in this category of patients. The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Grigorenko Elena Aleksandrovna
Candidate of Medical Sciences, Associate Professor, Professor of the Department of Cardiology and Internal Medicine, Belarusian State Medical University

220116, Republic of Belarus, Minsk, Dzerzhinsky Ave., 83

Tel.: +375 (296) 793007

E-mail: alegri@tut.by

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