Screening for significant coronary artery disease in high-risk renal transplant candidates

Gowdak, Luís Henrique Wolff; Paula, Flávio Jota de; César, Luiz Antonio Machado; Filho, Eulógio Emílio Martinez; Ianhez, L E; Krieger, Eduardo Moacyr; Ramires, José Antônio Franchini; Lima, José Jayme Galvão de

doi:10.1097/mca.0b013e3282f08e99

Cited by 60 publications

(60 citation statements)

References 14 publications

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“…12 Besides, chest pain is a poor indicator of CAD in this population. 14 Because of the high rates of microvascular dysfunction and LVH in CKD patients, angina without relevant CAD is reported to occur in 30-44% of these patients, in contrast with only 17% of the general population.…”

Section: Discussionmentioning

confidence: 99%

“…For CAD assessment, the patients were stratified in risk groups, according to Gowdak et al 12 The very high-risk group consisted of patients with symptoms suggestive of CAD or anginal equivalent. The highrisk group was composed of diabetics aged over 50 years and of patients with two or more classic CAD risk factors.…”

Section: Introductionmentioning

confidence: 99%

“…2,7,8 All risk factors interact and increase the cardiovascular mortality of CKD patients. [8][9][10][11][12] Mineral and bone metabolism disturbances, characterized by abnormal serum levels of calcium, phosphorus and parathyroid-hormone (PTH), are associated with extraosseous (arterial, valvular and myocardial) calcifications, and play an important role in the pathogenesis of myocardial hypertrophy and fibrosis. Vascular calcification is strongly associated with cardiovascular events and death.…”

Section: Introductionmentioning

confidence: 99%

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Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

Lordsleem¹,

Gueiros²,

Gueiros³

et al. 2012

J. Bras. Nefrol.

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ResumoIntrodução: Pacientes com doença renal crônica (DRC) apresentam sinergismo entre fatores de risco tradicionais para aterosclerose e emergentes derivados do estado urêmico. Objetivo: Traçar o perfil epidemiológico de um grupo de pacientes com DRC submetido à avaliação cardiológica. Métodos: Pacientes sintomáticos -com isquemia em cintilografia miocárdica e/ou disfunção sistólica ao ecodopplercardiograma -com idade maior que 50 anos e diabetes mellitus (DM) como causa da DRC e aqueles com dois ou mais fatores de risco ateroscleróticos realizaram cineangiocoronariografia. Assintomáticos -não diabéticos e sem fatores de risco -foram investigados com ecodopplercardiograma e aqueles com único fator de risco, por meio de ecodopplercardiograma e cintilografia. Resultados: Foram estudados 46 pacientes, 58,7% homens, idade de 50-70 ± 11,7 anos, 91,3% dialíticos. Tempo de hemodiálise: 61,96 ± 55,1 meses. Hipertensão arterial foi causa da DRC em 56,5%. Dos 28 pacientes (60,9%) submetidos à cineangiocoronariografia, 53,6% apresentaram doença arterial coronariana (DAC). Os pacientes foram divididos em três grupos: com DAC (A), sem DAC (B) e não submetidos à cineangiocoronariografia (C). Diferença significativa ocorreu entre os Grupos B e C na frequên-cia de índice tibiobraquial (ITB) anormal (p = 0,026), com ausência de ITB anormal no Grupo C e na média de idade, superior no B (p = 0,045). No Grupo A, 53,3% dos pacientes estavam em avaliação pré-paratireoidectomia (PTX). Conclusão: Este estudo confirmou a alta frequência de alterações cardiovasculares, inclusive de DAC, nos pacientes portadores de DRC, principalmente naqueles em diálise. Palavras-chave: Doença das coronárias. Insuficiência renal crônica. Inflamação. Aterosclerose. AbstRActIntroduction: Patients with chronic kidney disease (CKD) experiment a synergistic effect of the traditional and the emerging uremia-related risk factors for atherosclerosis. Objective: Draw the epidemiologic profile of a group of CKD patients who underwent cardiac evaluation. Methods: Symptomatic patients, patients with ischemia on myocardial scintigraphy and/or systolic dysfunction on echocardiography, patients older than 50 years and diabetes mellitus (DM) as a cause of CKD, and those with two or more risk factors underwent coronary angiography. Asymptomatic, non-diabetic patients and patients with no risk factors were investigated with echocardiography. Those with a single risk factor were investigated with echocardiography and scintigraphy. Results: 46 patients (58.7% men) were enrolled. Their mean age was 50.7 ± 11.7 years. 91.3% were on dialysis, for 61.96 ± 55.1 months. Hypertension was the cause of CKD in 56.5%. Of the 28 patients (60.9%) who underwent angiography, 53.6% had coronary artery disease (CAD). The patients were divided into three groups: those with CAD (A), those without CAD (B) and those who didn't undergo coronary angiography (C). A significant difference occurred only between groups B and C, as regards an abnormal ABI (p = 0.026), with no ABI abnormality in group...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

Lordsleem¹,

Gueiros²,

Gueiros³

et al. 2012

J. Bras. Nefrol.

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“…Based on the results of existing studies [134][135][136][137][138] , we propose the following risk stratification of asymptomatic patients with chronic renal failure from a cardiovascular standpoint being evaluated for kidney transplantation according to the presence or absence of three risk factors mentioned above:…”

Section: Risk Stratification For the Presence Of Coronary Artery Diseasementioning

confidence: 99%

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

Feitosa¹,

Marques²,

Caramelli³

et al. 2011

Arq. Bras. Cardiol.

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“…The authors conclude that patients presenting diabetes, peripheral artery disease, and previous infarction are under high risk of CAD, MACE, or both. Therefore, they must be submitted to invasive diagnostic procedure 6 . As for CAD evaluation strategies for those patients and their association to prognosis, De Lima et al 7 have published conclusive data showing that invasive coronary angiography (ICA) proved to be of higher prognostic value for CAD evaluation when compared to non-invasive tests (nuclear medicine and stress ECG) 7 .…”

Section: Introductionmentioning

confidence: 99%

Escore de cálcio coronariano prediz estenose e eventos na insuficiência renal crônica pré-transplante

Rosário

Lima

Parga

et al. 2010

Arq. Bras. Cardiol.

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Screening for significant coronary artery disease in high-risk renal transplant candidates

Cited by 60 publications

References 14 publications

Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

Avaliação cardiológica de pacientes portadores de doença renal crônica: quais as lições?

II Diretriz de Avaliação Perioperatória da Sociedade Brasileira de Cardiologia

Escore de cálcio coronariano prediz estenose e eventos na insuficiência renal crônica pré-transplante

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