Abstract
Due to the significant potential for perioperative and late cardiovascular complications, screening for coronary artery disease (CAD) has become common in candidates for orthotopic liver transplant (OLT).1–3 However, the optimal screening method in this population has not been established. Studies assessing the utility of dobutamine stress echocardiography (DSE) and single-photon emission computed tomographic (SPECT) technetium-99m sestamibi imaging in OLT candidates have been inconclusive.2–5 Diagnostic coronary angiography has been advocated for candidates with several cardiac risk factors.1 However, the American College of Cardiology/American Heart Association guidelines consider a class III indication for coronary angiography in patients awaiting liver transplant when they are >40 years of age, unless noninvasive testing reveals high risk for adverse outcome.6 We compared the sensitivity and specificity of single-photon emission computed tomography with coronary angiography for detection of CAD in a group of OLT candidates.
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