The prognostic utility of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease: The largest cohort to date.
Citation: Journal of Nuclear Cardiology. 29(1):101-110, 2022 Feb.PMID: 32632913Institution: MedStar Union Memorial HospitalForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Kidney Failure, Chronic | *Myocardial Perfusion Imaging | Adult | Aged | Exercise Test/mt [Methods] | Female | Humans | Kidney Failure, Chronic/dg [Diagnostic Imaging] | Male | Middle Aged | Myocardial Perfusion Imaging/mt [Methods] | Prognosis | Purines | Pyrazoles | Retrospective Studies | Tomography, Emission-Computed, Single-Photon/mt [Methods]Year: 2022ISSN:- 1071-3581
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
---|---|---|---|---|---|---|
Journal Article | MedStar Authors Catalog | Article | 32632913 | Available | 32632913 |
BACKGROUND: There are limited data on the prognostic utility of regadenoson SPECT myocardial perfusion imaging (MPI) in patients with end-stage renal disease (ESRD).
CONCLUSION: In the largest cohort to date, we demonstrated the incremental prognostic value of abnormal MPI in predicting MACE risk in ESRD patients. Given its size, our study provides improved risk estimates in this population compared to previous reports.
METHODS AND RESULTS: In a single-center, retrospective study, we analyzed consecutive ESRD patients who underwent regadenoson SPECT-MPI. The severity of MPI abnormalities and ischemic burden were determined quantitatively. The primary endpoint was major adverse cardiac events (MACE), defined as the composite of cardiac death or myocardial infarction. Among 1,227 subjects (mean age 54 +/- 13 years, 47% men), 60 (5%) MACE were observed during a mean follow-up of 2.5 +/- 1.8 years. The presence and severity of MPI abnormalities and ischemic burden were associated with a stepwise increase in MACE risk. Abnormal MPI (SSS >= 4) was associated with increased MACE risk, independent and incremental to relevant clinical covariates; adjusted hazard ratio, 1.95; 95% confidence interval, 1.15-3.32; DELTAchi2 = 5.97; P = .013. Myocardial ischemia (SDS >= 2) was associated with a trend towards increased MACE risk; adjusted hazard ratio, 1.63; 95% confidence interval, 0.96-2.77; DELTAchi2 = 3.12; P = .072.
English