Could Calcium Score Serve as a Screening Tool to Rule Out Significant Coronary Artery Stenosis in Pre-liver and Pre-renal Transplant Patients?

OBJECTIVE: This study aims to assess the diagnostic value of the coronary artery calcium score (CACS) to predict significant coronary artery stenosis (SCAS) in presolid organ transplant patients with a moderate and high risk of coronary artery disease. METHODS: In this retrospective HIPAA-compliant study, all pre-liver/kidney transplant patients with intermediate or high risk of coronary artery disease who underwent cardiac CT angiogram (CCTA) and CACS between January 1, 2018 and December 31, 2022 were reviewed. CACS was assessed according to the Agatston score. SCAS was defined as ≥50% diameter stenosis on CCTA. The potential to predict SCAS was assessed by computing the area under the receiver curve (AUC), and the sensitivity and specificity of CACS in diagnosing SCAS were calculated at various CACS thresholds. RESULTS: A total of 291 patients (81; 28% female) with a mean age of 57.7±9.9 years, were included. The median CACS was 772 (IQR: 320 to 1892) in patients with SCAS versus 23 (IQR: 0 to 187) in those without SCAS ( P