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- Title
Myocardial perfusion imaging for predicting cardiac events in Japanese patients with advanced chronic kidney disease: 1-year interim report of the J-ACCESS 3 investigation.
- Authors
Joki, Nobuhiko; Hase, Hiroki; Kawano, Yuhei; Nakamura, Satoko; Nakajima, Kenichi; Hatta, Tsuguru; Nishimura, Shigeyuki; Moroi, Masao; Nakagawa, Susumu; Kasai, Tokuo; Kusuoka, Hideo; Takeishi, Yasuchika; Momose, Mitsuru; Takehana, Kazuya; Nanasato, Mamoru; Yoda, Shunichi; Nishina, Hidetaka; Matsumoto, Naoya; Nishimura, Tsunehiko
- Abstract
Purpose: Whether myocardial perfusion imaging (MPI) can predict cardiac events in patients with advanced conservative chronic kidney disease (CKD) remains unclear. Methods: The present multicenter prospective cohort study aimed to clarify the ability of MPI to predict cardiac events in 529 patients with CKD and estimated glomerular filtration rates (eGFR) < 50 ml/min per 1.73 without a definitive diagnosis of coronary artery disease. All patients were assessed by stress-rest MPI with Tc-tetrofosmin and analyzed using summed defect scores and QGS software. Cardiac events were analyzed 1 year after registration. Results: Myocardial perfusion abnormalities defined as summed stress score (SSS) ≥4 and ≥8 were identified in 19 and 7 % of patients, respectively. At the end of the 1-year follow-up, 33 (6.2 %) cardiac events had occurred that included cardiac death, sudden death, nonfatal myocardial infarction, and hospitalization due to heart failure. The event-free rates at that time were 0.95, 0.90, and 0.81 for groups with SSS 0-3, 4-7, and ≥8, respectively ( p = 0.0009). Thus, patients with abnormal SSS had a higher incidence of cardiac events. Multivariate Cox regression analysis showed that SSS significantly impacts the prediction of cardiac events independently of eGFR and left ventricular ejection fraction. Conclusion: MPI would be useful to stratify patients with advanced conservative CKD who are at high risk of cardiac events without adversely affecting damaged kidneys.
- Subjects
MYOCARDIAL perfusion imaging; HEART disease diagnosis; CHRONIC kidney failure; LONGITUDINAL method; CORONARY disease; DIAGNOSIS; GLOMERULAR filtration rate; PATIENTS
- Publication
European Journal of Nuclear Medicine & Molecular Imaging, 2014, Vol 41, Issue 9, p1701
- ISSN
1619-7070
- Publication type
Article
- DOI
10.1007/s00259-014-2781-z