Incremental value of coronary computed tomography angiography-based CAD-RADS score and ΔFFR(CT) to the CAR-OLT score in predicting major adverse cardiovascular events after liver transplantation.

内容摘要

To evaluate the association between coronary computed tomography angiography (CCTA)-based parameters and major adverse cardiovascular events (MACE) in liver transplantation (LT) recipients, and assess the incremental prognostic value of CCTA over the CAR-OLT score. A dual-center 395 LT recipients were enrolled. The endpoints were 1-year MACE and MACE after LT. The CAR-OLT score was calculated. An Imaging model for predicting 1-year MACE after LT was constructed based on the independent CCTA-based predictors. A Combined model was established by integrating the independent imaging predictors with the CAR-OLT score. Coronary artery disease-reporting and data system (CAD-RADS) score (Odds Ratio [OR] 3.15, P = 0.020) and CT-derived trans-lesional fractional flow reserve gradient across the lesion with the highest-grade stenosis (&#x394;FFRCT) (OR 2.23, P = 0.001) were identified as the independent imaging predictors for 1-year MACE after LT. The Combined model outperformed the CAR-OLT score with a higher area under the curve for predicting 1-year MACE after LT (0.793 vs. 0.668, P = 0.044) and a higher C-index for predicting MACE after LT (0.766 vs. 0.659, P < 0.001). CAD-RADS score and &#x394;FFRCT can predict MACE after LT and provide incremental value to the CAR-OLT score.