Usefulness of Stress Myocardial Perfusion Imaging and Baseline Clinical Factors for Predicting Cardiovascular Events in Patients With Prior Coronary Artery Disease

Furuhashi, Tatsuhiko; Moroi, Masao; Awaya, Toru; Minakawa, Megumi; Masai, Hirofumi; Kunimasa, Taeko; Fukuda, Hiroshi

doi:10.1253/circj.cj-14-0018

Cited by 8 publications

(4 citation statements)

References 41 publications

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“…Only PAD, diagnosed by the palpation method, was a predictor of combined cardiovascular events and death from any cause after the results were adjusted for other risk factors. In the literature, several risk factors associated with PAD in patients with CKD are mentioned [ 1 , 23 ]. In our study, the lack of impact of other classic risk factors on these outcomes may have been a consequence of the small number of patients in our sample.…”

Section: Discussionmentioning

confidence: 99%

Peripheral Artery Disease Diagnosed by Pulse Palpation as a Predictor of Coronary Artery Disease in Patients with Chronic Kidney Disease

Dos Santos,

Gowdak,

David-Neto

et al. 2023

JCM

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There is a need of simple, inexpensive, and reliable noninvasive testing to predict coronary artery disease (CAD) in patients with chronic kidney disease (CKD), where the prevalence of cardiovascular (CV) events and death is elevated. We analyzed the association between peripheral artery disease (PAD) and CAD in 201 patients with stage 5 CKD on dialysis using a prospective observational cohort. Diagnosis of PAD by both palpation and USD were significantly correlated. In patients with PAD diagnosed by palpation, CAD was observed in 80%, while in those diagnosed by USD, CAD was present in 79.1%. The absence of a pulse by palpation predicted CAD with a sensitivity of 55% and a specificity of 76%; USD showed a sensitivity of 62% and specificity of 60% to predict CAD. The risk of combined serious CV events and death was significantly higher in subjects with PAD diagnosed by palpation, but not by USD. PAD assessed by palpation also correlated with the occurrence of multivessel CAD and with the probability of coronary intervention. Both methods are moderately useful for predicting CAD, but PAD diagnosis by palpation was a better predictor of combined CV events and death and was also associated with CAD severity and likelihood of intervention.

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Section: Discussionmentioning

confidence: 99%

Peripheral Artery Disease Diagnosed by Pulse Palpation as a Predictor of Coronary Artery Disease in Patients with Chronic Kidney Disease

Dos Santos,

Gowdak,

David-Neto

et al. 2023

JCM

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“…35 However, studies including patients with prior CAD-in contrast to our study-found smoking and diabetes to be independent predictors for cardiovascular events in ESRD patients. 36,37 It might also be a promising approach to survey at the accumulated burden of risk factors including traditional risk factors as well as left-ventricular hypertrophy and dialysis vintage as defined by the AHA/ACC statement. 11,38 In our patient cohort, left ventricular hypertrophy was frequently detected, whereas left ventricular volumes and ejection fraction were normal on average.…”

Section: Discussionmentioning

confidence: 99%

Prognostic implication of myocardial perfusion and contractile reserve in end-stage renal disease: A direct comparison of myocardial perfusion scintigraphy and dobutamine stress echocardiography

Bautz

Stypmann

Reiermann

et al. 2022

Journal of Nuclear Cardiology

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Background We aimed to compare the prognostic value of myocardial perfusion scintigraphy (MPS) and dobutamine stress echocardiography (DSE) in patients with end-stage renal disease (ESRD) without known coronary artery disease. Methods Two-hundred twenty-nine ESRD patients who applied for kidney transplantation at our centre were prospectively evaluated by MPS and DSE. The primary endpoint was a composite of myocardial infarction (MI) or all-cause mortality. The secondary endpoint included MI or coronary revascularization (CR) not triggered by MPS or DSE at baseline. Results MPS detected reversible ischemia in 31 patients (13.5%) and fixed perfusion defects in 13 (5.7%) patients. DSE discovered stress-induced wall motion abnormalities (WMAs) in 28 (12.2%) and at rest in 18 (7.9%) patients. MPS and DSE results agreed in 85.6% regarding reversible defects (κ = 0.358; P < .001) and in 90.8% regarding fixed defects (κ = 0.275; P < .001). Coronary angiography detected relevant stenosis > 50% in only 15 of 38 patients (39.5%) with pathological findings in MPS and/or DSE. At a median follow-up of 8 years and 10 months, the primary endpoint occurred in 70 patients (30.6%) and the secondary endpoint in 24 patients (10.5%). The adjusted Cox hazard ratios (HRs) for the primary endpoint were 1.77 (95% CI 1.02-3.08; P = .043) for perfusion defects in MPS and 1.36 (95% CI 0.78-2.37; P = ns) for WMA in DSE. The secondary endpoint was significantly correlated with the findings of both modalities, MPS (HR 3.21; 95% CI 1.35-7.61; P = .008) and DSE (HR 2.67; 95% CI 1.15-6.20; P = .022). Conclusion Perfusion defects in MPS are a stronger determinant of all-cause mortality, MI and the need for future CR compared with WMAs in DSE. Given the complementary functional information provided by MPS vs DSE, results are sometimes contradictory, which may indicate differences in the underlying pathophysiology.

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“…[8][9][10] Indeed, studies have shown that the grade of myocardial ischemia on MPI is an important predictor of cardiovascular events among patients with a history of CAD. [11][12][13][14] Moreover, the rate of cardiovascular events might be reduced in patients with no significant reversible defect abnormalities and preserved left ventricular ejection fraction (LVEF), regardless of the severity of myocardial infarction (MI). [12][13][14] These studies show that the grade of the reversible defect, as assessed by stress MPI, and decreasing LVEF are important cardiac risk factors.…”

Section: Introductionmentioning

confidence: 99%

“…An SSS <4 was considered normal, 9,20 and a summed difference score <2 was taken to indicate that no significant myocardial ischemia was present. 11,21,22 The mean washout rate of thallium was also calculated to assess the possibility of multiple-vessel disease and balanced ischemia.…”

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confidence: 99%

Cardiovascular prognosis in patients with preserved left ventricular ejection fraction and no significant ischemia

Furuhashi¹,

Moroi²

2017

RRCC

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Usefulness of Stress Myocardial Perfusion Imaging and Baseline Clinical Factors for Predicting Cardiovascular Events in Patients With Prior Coronary Artery Disease

Cited by 8 publications

References 41 publications

Peripheral Artery Disease Diagnosed by Pulse Palpation as a Predictor of Coronary Artery Disease in Patients with Chronic Kidney Disease

Peripheral Artery Disease Diagnosed by Pulse Palpation as a Predictor of Coronary Artery Disease in Patients with Chronic Kidney Disease

Prognostic implication of myocardial perfusion and contractile reserve in end-stage renal disease: A direct comparison of myocardial perfusion scintigraphy and dobutamine stress echocardiography

Cardiovascular prognosis in patients with preserved left ventricular ejection fraction and no significant ischemia

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