Significance of worsening renal function and nuclear cardiology for predicting cardiac death in patients with known or suspected coronary artery disease

Abstract

Baseline and follow-up eGFRs as well as nuclear variables are useful to predict cardiac death in patients with known/suspected CAD.

Correlation between early revascularization and major cardiac events demonstrated by ischemic myocardium in Japanese patients with stable coronary artery disease

“…We retrospectively investigated 3581 patients with known or suspected CAD who underwent rest 201 Tl and stress 99m Tctetrofosmin myocardial perfusion SPECT [9,[11][12][13][14][15][16][17][18][19] at Nihon University Itabashi Hospital between October 2004 and March 2011 and who had data on a three-year follow-up. We excluded patients aged 20 years, those with hypertrophic or dilated cardiomyopathy, those with serious valvular heart disease, those with heart failure being class III or higher New York Heart Association (NYHA) functional classification, and those with onset of acute coronary syndromes within three months [6,10].…”

Cardiac Event Risk Stratification Using Nuclear Cardiology in Japanese Patients with Coronary Artery Disease

“…Furthermore, taking notice of a relationship between cardiac death and eGFR reduction within one year (∆eGFR) in CKD patients, we stratified the risk of cardiac death using cut-off SSS (= 9) and ∆eGFR (= 10) based on results of receiver operating characteristic analysis and identified three variables, i.e. baseline eGFR, ∆eGFR, and SSS, as significant predictors of cardiac death [24]. In addition, Kaplan-Meier survival curves for non-CKD and CKD patients stratified with both cut-off SSS and ∆eGFR indicated significant risk stratification of cardiac death and CKD patients with SSS ≥ 9 and ∆eGFR ≥ 10 had the poorest prognosis in particular (Figure 1).…”

“…CKD: chronic kidney disease; non-CKD patients: eGFR ≥ 60, n = 1,139; CKD patients: eGFR < 60, n = 600 [24].…”

Quantification of myocardial perfusion reserve using dynamic SPECT images of patients with chronic kidney disease

“…Chronic kidney disease (CKD) is an independent risk factor for cardiovascular disease. The incidence of cardiac events and the mortality rate in patients with severe CKD is high [1][2][3][4]. Cardiovascular events associated with cardiovascular stenosis and other factors unrelated to coronary stenosis have been reported and the possibility of coronary microvascular dysfunction has been suggested [5].…”