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Clinical significance of multidetector coronary computed tomography angiography to evaluate the prevalence and severity of coronary artery disease in asymptomatic kidney transplantation recipients

Authors
 S.H. Lee  ;  K.H. Huh  ;  B.K. Kim  ;  B.W. Choi  ;  Y.J. Kim  ;  Y.S. Kim  ;  B.S. Kim 
Citation
 Transplantation Proceedings, Vol.47(3) : 675-678, 2015 
Journal Title
 Transplantation Proceedings 
ISSN
 0041-1345 
Issue Date
2015
MeSH
Adult ; Coronary Angiography/methods* ; Coronary Artery Disease/diagnostic imaging* ; Coronary Artery Disease/epidemiology* ; Female ; Humans ; Kidney Transplantation/adverse effects* ; Male ; Middle Aged ; Multidetector Computed Tomography/statistics & numerical data* ; Predictive Value of Tests ; Prevalence ; Risk Factors
Abstract
BACKGROUND: Coronary artery disease (CAD) is one of the leading causes of mortality in kidney transplantation (KT) recipients. Noninvasive coronary angiography with the use of multidetector computerized tomography (MDCT) is feasible with high sensitivity and negative predictive value to evaluate CAD. However, few studies have been conducted to elucidate the applicability of MDCT in KT. This study was designed to evaluate the prevalence and severity of CAD with the use of MDCT angiography in asymptomatic KT recipients. METHODS: From September 2011 to November 2013, MDCT angiography was performed on 90 renal transplant recipients who had no pre-transplantation CAD history and stabilized post-transplantation renal function for 6-18 months. According to the MDCT results, we divided our study population into 2 groups: The no-CAD group (n = 36; 40.0%) and the CAD group (n = 54; 60.0%). Severity of CAD was categorized as follows: mild CAD, 1 vessel obstructive, 2 vessels obstructive (or in the proximal left anterior descending), and 3 vessels obstructive (or left main). RESULTS: Among the risk factors, pre-transplantation diabetes mellitus and lower levels of high-density lipoprotein, higher parathyroid hormone levels, higher coronary artery calcification scores, and rejection episodes were independent factors for CAD. Thirty-two (59.3%) of the CAD group had mild obstructive lesions and 22 (40.7%) had obstructive lesions in >1 vessel according to MDCT angiography. CONCLUSIONS: MDCT angiography is a useful and noninvasive method for detecting CAD even in asymptomatic KT recipients.
Full Text
http://www.sciencedirect.com/science/article/pii/S0041134515001104
DOI
10.1016/j.transproceed.2014.12.032
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Seok(김범석) ORCID logo https://orcid.org/0000-0002-5732-2583
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Young Jin(김영진) ORCID logo https://orcid.org/0000-0002-6235-6550
Kim, Yu Seun(김유선) ORCID logo https://orcid.org/0000-0002-5105-1567
Choi, Byoung Wook(최병욱) ORCID logo https://orcid.org/0000-0002-8873-5444
Huh, Kyu Ha(허규하) ORCID logo https://orcid.org/0000-0003-1364-6989
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140017
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