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The prognostic utility of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease: The largest cohort to date.

MedStar author(s):

1071-3581

Name of journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyAbstract: 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.All authors: Doukky R, Iskander F, Iskander M, Khan R, Kolkailah AA, Patel PPOriginally published: Journal of Nuclear Cardiology. 2020 Jul 06Fiscal year: FY2021Digital Object Identifier:

https://dx.doi.org/10.1007/s12350-020-02259-1

Date added to catalog: 2020-08-26

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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.

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