10th Japan-Korea transplantation forumKidney transplantationClinical Significance of Multidetector Coronary Computed Tomography Angiography to Evaluate the Prevalence and Severity of Coronary Artery Disease in Asymptomatic Kidney Transplantation Recipient

- This study was designed to evaluate the prevalence and severity of CAD with the use of coronary CT angiography in asymptomatic KT recipients.
- Among the 90 patients, 54 (60.0%) were in the CAD group. Of the recipients with CAD, 48.1% had CAC scores <100 and 27.8% had CAC scores >400.
- CAD is highly prevalent, and MDCT angiography is a useful and noninvasive method for detecting CAD even in asymptomatic KT recipients.

BackgroundCoronary 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.MethodsFrom 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).ResultsAmong 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.ConclusionsMDCT angiography is a useful and noninvasive method for detecting CAD even in asymptomatic KT recipients.