DETERMINANTS OF TRANSPLANT-RELATED CORONARY CALCIUM DETECTED BY ULTRAFAST COMPUTED-TOMOGRAPHY SCANNING

Coronary calcium detected by ultrafast computed tomography (Ci) has be en shown to be a marker of coronary artery disease in heart transplant recipients. The objective of this study was to examine the possible d eterminants of coronary calcium after heart transplantation. Over a 15 -month period, 102 consecutive cardiac transplant recipients (mean age 53 years, 88 men) underwent ultrafast CT scanning of the heart, in ad dition to coronary angiography, to determine coronary calcium score on their annual follow-up (a median of 4.6 years [range 63 days to 9.1 y ears] after transplant). The following data were also recorded: the re cipient's sex and dare of birth, date of transplantation, date of ultr afast computed tomography and coronary angiography; recipient pretrans plant diagnosis, history of diabetes mellitus and systemic hypertensio n, fasting lipid profile, immunosuppression, number of rejection episo des, and donor organ ischemic time. Forty six patients (45.1%) had tot al calcium scores >0 and 41 (40.2%) had at least 1 major coronary with angiographic narrowing >24%. On vnivariate analysis, coronary calcium was significantly associated with dyslipoproteinemia, total cholester ol was >6.0 mmol/L (240 mg/dl), triglycerides were >3.0 mmol/L (265 mg /dl), and lipoprotein(a) >30 mg/dl; greater than or equal to 25% angio graphic disease was significantly associated with coronary calcium and dyslipoproteinemia. Logistic regression revealed that dyslipoproteine mia, systemic hypertension, and donor ischemic time were significant p redictors of coronary calcium in transplanted hearts. We conclude that the prevalence of coronary calcium in heart transplant recipients is high and is related to recipient dyslipoproteinemia, systemic hyperten sion,and donor organ ischemic time, (C) 1997 by Excerpta Medica, Inc.