Table 2.
Comparison of recipient characteristics stratified by 30 or 90-day major adverse cardiovascular events (MACE) after liver transplantation
| Characteristic | No 90-day MACE N = 32,442 |
+30-day MACE N = 368 |
+90-day MACE n = 474 |
P value* |
| Recipient Age, % | < .0001 | |||
| 18–44 | 15.0 | 7.6 | 7.4 | |
| 45–64 | 73.5 | 71.7 | 73.2 | |
| 65+ | 11.6 | 20.7 | 19.4 | |
| Female, % | 32.6 | 32.3 | 32.7 | .96 |
| Race & ethnicity, % | .08 | |||
| Non-Hispanic White | 73.0 | 79.4 | 78.3 | |
| Non-Hispanic Black | 9.6 | 9.0 | 9.5 | |
| Hispanic | 11.0 | 6.8 | 7.2 | |
| Asian | 5.4 | 4.6 | 4.6 | |
| Other | 1.0 | 0.3 | 0.4 | |
| Highest education level, % | .26 | |||
| Less than high school | 4.1 | 3.5 | 3.4 | |
| High school | 40.1 | 35.6 | 37.1 | |
| College+ | 38.5 | 44.8 | 42.8 | |
| Unknown | 17.2 | 16.0 | 16.7 | |
| Primary indication for transplant, % | .0004 | |||
| Hepatitis C | 24.3 | 19.4 | 19.4 | |
| Hepatocellular carcinoma | 20.2 | 17.1 | 17.1 | |
| Alcohol | 17.4 | 22.2 | 22.2 | |
| NASH | 9.6 | 13.4 | 13.9 | |
| Other | 28.5 | 27.2 | 27.4 | |
| Payor Status, % | .0004 | |||
| Private | 62.1 | 59.2 | 61.6 | |
| Medicare | 20.5 | 28.3 | 26.8 | |
| Medicaid | 13.9 | 9.8 | 8.9 | |
| Other* | 3.5 | 2.3 | 2.7 | |
| Functional status at transplant, % | .03 | |||
| Independent | 44.8 | 37.5 | 38.8 | |
| Partially dependent | 20.9 | 26.1 | 24.3 | |
| Totally dependent | 24.2 | 27.2 | 27.6 | |
| Unknown | 10.1 | 9.2 | 9.3 | |
| Medical condition at transplant, % | .003 | |||
| Not hospitalized | 71.3 | 66.0 | 66.0 | |
| Hospitalized not in ICU | 17.2 | 17.5 | 17.5 | |
| In ICU | 11.5 | 16.5 | 16.5 | |
| Calculated MELD score at transplant, mean |
20.0 ± 11.1 | 21.9 ± 11.7 | 21.8 ± 11.8 | .0008 |
| Days on waiting list, mean | 209.5 ± 360.5 | 234.3 ±448.6 | 230.5 ±189.5 | .21 |
| Simultaneous liver-kidney, % | 7.0 | 10.3 | 9.5 | .04 |
| CVD risk factors at transplant, % | ||||
| Obesity | 34.0 | 36.7 | 39.9 | .007 |
| Hypertension | 35.2 | 39.7 | 40.1 | .03 |
| Diabetes | 23.6 | 21.5 | 22.2 | .45 |
| Chronic kidney disease | 14.0 | 20.1 | 19.0 | .0018 |
| Cardiac dysrhythmia, any | 14.3 | 41.9 | 40.9 | < .0001 |
| Atrial fibrillation | 5.6 | 33.2 | 32.5 | < .0001 |
| Ischemic heart disease | 7.3 | 13.3 | 13.3 | < .0001 |
| Prior myocardial infarction | 2.4 | 5.2 | 5.3 | <.0001 |
| Heart failure | 3.0 | 14.4 | 12.9 | < .0001 |
| Stroke or TIA | 1.4 | 2.2 | 1.9 | .37 |
| Hyperlipidemia | 1.3 | 1.6 | 1.9 | .29 |
| Peripheral Vascular Dz | 0.3 | 0 | 0 | .27 |
| Thromboembolism | 11.7 | 13.6 | 13.9 | .13 |
| Pulmonary Embolism | 0.8 | 1.6 | 1.5 | .08 |
| Current/former smoker | 15.2 | 18.3 | 18.3 | .08 |
| Family history of CVD | 1.1 | 1.4 | 1.7 | .24 |
| Characteristic | No MACE N = 32,442 |
+30-day MACE N = 368 |
+90-day MACE n = 474 |
P value* |
| Pulmonary Comorbidities, % | ||||
| Pulmonary Hypertension | 3.3 | 6.3 | 6.3 | .0002 |
| Respiratory failure on ventilator | 6.1 | 8.4 | 9.5 | .002 |
| Asthma/COPD | 10.0 | 13.9 | 14.1 | .0032 |
| Obstructive sleep apnea | 1.7 | 4.1 | 4.0 | .0001 |
| Complications of ESLD, % | ||||
| Ascites at transplant | 40.2 | 43.5 | 44.7 | .05 |
| Variceal Bleed | 20.6 | 22.8 | 21.7 | .55 |
| Hepatic Encephalopathy | 17.4 | 21.2 | 24.5 | <.0001 |
| TIPS | 8.3 | 7.6 | 7.4 | .47 |
| Hepatorenal syndrome | 14.6 | 17.9 | 19.6 | .002 |
| Portal Vein Thrombosis | 6.2 | 8.7 | 8.7 | .03 |
| SBP | 2.7 | 4.1 | 4.0 | .09 |
| Hepatocellular carcinoma | 3.1 | 2.2 | 1.9 | .15 |
| Hepatopulmonary syndrome | 0.3 | 1.1 | 1.1 | .006 |
| Charlson comorbidities, % | < .0001 | |||
| 0 | 35.0 | 28.8 | 29.3 | |
| 1 | 40.1 | 35.6 | 35.4 | |
| 2 | 19.7 | 26.1 | 26.4 | |
| 3 | 4.3 | 7.1 | 6.5 | |
| 4 | 0.8 | 2.5 | 2.3 | |
| 5+ | 0.1 | 0 | 0 | |
| Laboratory Values at time of transplant, mean ± SD |
||||
| Creatinine (mg/dL) | 1.6 ± 1.4 | 1.9 ± 1.8 | 1.9 ± 1.7 | < .0001 |
| ALT (U/L) | 178.1 ± 586.1 | 111.7± 296.4 | 119.4 ± 322.0 | .02 |
| Total bilirubin (mg/dL) | 8.3 ± 11.0 | 8.7 ±10.8 | 8.8 ± 10.8 | .30 |
| Albumin | 3.0 ± 0.7 | 3.1 ± .72 | 3.0 ± .7 | .03 |
| INR | 1.9 ± 1.7 | 2.0 ± 1.2 | 2.0 ± 1.2 | .45 |
| Sodium | 135.9 ± 5.2 | 136.2 ± 5.4 | 136.4 ± 5.4 | .06 |
| BMI (kg/m2) at transplant, mean | 28.2 ± 28.1 | 28.5 ± 28.0 | 28.7 ± 5.9 | .03 |
chi-square or Fisher’s exact test for categorical variables, t test for continuous variables for 90-day MACE. Findings were similar for 30-day MACE
Abbreviations: ALT, alanine aminotransferase; BMI, body mass index; COPD, chronic obstructive pulmonary disease; CVD, cardiovascular disease; ESLD, end-stage liver disease; ICU, intensive care unit; INR, international normalized ratio; LOS, length of stay; MACE, major adverse cardiovascular event MELD, model for end-stage liver disease score; NASH, nonalcoholic steatohepatitis; No, number; SBP, spontaneous bacterial peritonitis; SD, standard deviation; TIA, transient ischemic attack; TIPS, transhepatic intravenous portosystemic shunt