Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/22578
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dc.contributor.authorKoshy, Anoop N-
dc.contributor.authorGow, Paul J-
dc.contributor.authorHan, Hui-Chen-
dc.contributor.authorTeh, Andrew W-
dc.contributor.authorJones, Robert M-
dc.contributor.authorTestro, Adam G-
dc.contributor.authorLim, Han S-
dc.contributor.authorMcCaughan, Geoffrey-
dc.contributor.authorJeffrey, Gary P-
dc.contributor.authorCrawford, Michael-
dc.contributor.authorMacdonald, Graeme-
dc.contributor.authorFawcett, Jonathan-
dc.contributor.authorWigg, Alan-
dc.contributor.authorChen, John W C-
dc.contributor.authorGane, Edward J-
dc.contributor.authorMunn, Stephen R-
dc.contributor.authorClark, David J-
dc.contributor.authorYudi, Matias B-
dc.contributor.authorFarouque, Omar-
dc.date2020-02-03-
dc.date.accessioned2020-02-11T01:18:16Z-
dc.date.available2020-02-11T01:18:16Z-
dc.date.issued2020-02-03-
dc.identifier.citationEuropean heart journal. Quality of care & clinical outcomes 2020; online first: 3 February-
dc.identifier.urihttp://ahro.austin.org.au/austinjspui/handle/1/22578-
dc.description.abstractThere has been significant evolution in operative and post-transplant therapies following liver transplantation (LT). We sought to study their impact on cardiovascular mortality, particularly in the longer-term. A retrospective cohort study was conducted of all adult LTs in Australia and New Zealand across three 11-year eras from 1985 to assess prevalence, modes and predictors of early (≤30-day) and late (>30-day) cardiovascular mortality. A total of 4,265 patients were followed-up for 37,409 person-years. Overall, 1,328 patients died, and cardiovascular mortality accounted for 228 (17.2%) deaths. Both early and late cardiovascular mortality fell significantly across the eras (p < 0.001). However, cardiovascular aetiologies were consistently the leading cause of early mortality and accounted for ∼40% of early deaths in the contemporary era. Cardiovascular deaths occurred significantly later than non-cardiac aetiologies (8.8 vs 5.2 years, p < 0.001). On multivariable Cox-regression, coronary artery disease (HR 4.6,95%CI 1.2-21.6, p = 0.04) and era of transplantation (HR 0.44; 95%CI 0.28-0.70, p = 0.01) were predictors of early cardiovascular mortality while advancing age (HR 1.05, 95%CI 1.02-1.10, p = 0.005) was an independent predictors of late cardiovascular mortality. Most common modes of cardiovascular death were cardiac arrest, cerebrovascular events and myocardial infarction. Despite reductions in cardiovascular mortality post-LT over 30-years, they still account for a substantial proportion of early and late deaths. The late occurrence of cardiovascular deaths highlights the importance of longitudinal follow-up to study the efficacy of targeted risk-reduction strategies in this unique patient population.-
dc.language.isoeng-
dc.subjectcardiac death-
dc.subjectcardiovascular mortality-
dc.subjectcirrhotic cardiomyopathy-
dc.subjectliver transplantation-
dc.subjectlong-term-
dc.subjecttransplantation-
dc.titleCardiovascular Mortality following Liver Transplantation: Predictors and Temporal Trends over 30 years.-
dc.typeJournal Article-
dc.identifier.journaltitleEuropean heart journal. Quality of care & clinical outcomes-
dc.identifier.affiliationSchool of Medicine, The University of Queensland, Brisbane, Australiaen
dc.identifier.affiliationVictorian Liver Transplant Unit, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationSir Charles Gardiner Hospital, Perth, Australiaen
dc.identifier.affiliationSchool of Medicine, University of Western Australia, Nedlands, Australiaen
dc.identifier.affiliationPrincess Alexandra Hospital, Brisbane, Australiaen
dc.identifier.affiliationFlinders Medical Centre, Adelaide, Australiaen
dc.identifier.affiliationRoyal Prince Alfred Hospital, Sydney, Australiaen
dc.identifier.affiliationUniversity of Sydney, Sydney, Australiaen
dc.identifier.affiliationDepartment of Cardiology, Austin Health, Heidelberg, Victoria, Australiaen
dc.identifier.affiliationThe University of Melbourne, Parkville, Victoria, Australiaen
dc.identifier.affiliationAuckland City Hospital, New Zealand-
dc.identifier.doi10.1093/ehjqcco/qcaa009-
dc.identifier.orcid0000-0002-8741-8631-
dc.identifier.orcid0000-0002-3706-4150-
dc.identifier.pubmedid32011663-
dc.type.austinJournal Article-
Appears in Collections:Journal articles
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