Diabetes May Be an Independent Predictor of Sudden Cardiac Death After Liver Transplantation

The following article is part of conference coverage from the American College of Cardiology (ACC.20) /World Congress of Cardiology. The Cardiology Advisor‘s staff is reporting on research conducted by leading experts in cardiology. Check back for the latest news from the ACC.20.

The presence of diabetes before liver transplantation may be an independent predictor of sudden cardiac death after the procedure, according to study results intended to be presented at the American College of Cardiology’s 69th Annual Scientific Session.

Sudden cardiac death has been recognized as a common type of cause-specific mortality after liver transplantation. To better understand the predictors of sudden cardiac death, researchers prospectively collected data on clinical outcomes after liver transplantation from 4538 adults who visited 6 centers in Australia and New Zealand between 1985 and 2017 (median follow-up, 10.5 years).

A panel of 2 cardiologists and a transplant physician assessed the cause of death in this cohort, and cases of sudden cardiac death were defined as witnessed arrests or unwitnessed cases, in which patients were deemed to be healthy at the last time of contact. In this cohort, there were 240 cardiovascular-related deaths (5.3%), of which 30.4% were categorized as sudden cardiac death. Sudden cardiac death vs death with a different etiology occurred earlier after liver transplantation (7.5 vs 9.0 years, respectively; P =.03).

The presence of diabetes before liver transplantation was identified as an independent predictor of sudden cardiac death after adjusting for univariate predictors (ie, coronary artery disease, age, and steatohepatitis of nonalcoholic origin) in a multivariate regression analysis (hazard ratio, 2.5; 95% CI, 1.1-6.0; P <.001).

“Studies are needed to assess mechanisms of [sudden cardiac death] following [liver transplantation], and whether intensive risk factor modification in the post-[liver transplantation] diabetic population improves survival,” concluded the study authors.

Reference

Koshy AN, Gow PJ, Han HC, et al. Diabetes is an independent predictor of sudden cardiac death following liver transplantation: results from the Australian and New Zealand Liver Transplant Registry over 30 years. Intended to be presented at: American College of Cardiology’s 69th Annual Scientific Session; March 28-30, 2020; Chicago, IL.

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