Impact of chronic kidney disease and stress myocardial perfusion imaging as a predictor of cardiovascular events
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Tatsuhiko Furuhashi Masao Moroi Nobuhiko Joki Hiroki Hase Hirofumi Masai Taeko Kunimasa Ryo Nakazato Hiroshi Fukuda Kaoru Sugi
- چاپ و سال / کشور: 2011
Description
Background Stress myocardial perfusion imaging (MPI) is an established means of predicting cardiovascular events and is suitable in chronic kidney disease (CKD) patients. We aimed to evaluate the prognostic value of CKD parameters and an abnormal stress MPI for cardiovascular events. Methods A total of 495 patients with suspected coronary artery disease (CAD) or history of CAD including 130 CKD patients not undergoing hemodialysis, underwent stress MPI (313 males, mean age 70 years) and were followed up for 14 months (mean period). CKD was defined as an estimated GFR of\60 ml/min/1.73 m2 and/or persistent proteinuria. Cardiovascular events were defined as sudden cardiac death, acute coronary syndrome and congestive heart failure requiring hospitalization. Results Cardiovascular events occurred in 41 (8.3%) patients. Multivariate Cox regression analysis indicated that CKD [hazard ratio (HR) = 3.76, p\0.001] and a stress MPI summed difference score (SDS) of C2 (HR = 3.78, p\0.001) were independent predictors of cardiovascular events; CKD plus abnormal stress MPI was also a strong predictor of cardiovascular events (non-CKD and SDS \2 vs. CKD and SDS C2, HR = 15.9, p\0.001). Conclusion Both CKD and myocardial ischemia detected by stress MPI are independent predictors for cardiovascular events. Coexistence of CKD and myocardial ischemia detected by stress MPI is more useful for short-term risk stratification of cardiovascular events.
Ann Nucl Med DOI 10.1007/s12149-011-0507-x Received: 21 March 2011 / Accepted: 30 May 2011
