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

Abstract

BACKGROUND:

There are limited data on the prognostic utility of regadenoson SPECT myocardial perfusion imaging (MPI) in patients with end-stage renal disease (ESRD).

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; Δχ2 = 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; Δχ2 = 3.12; P = .072.

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.

• Authors: Ahmed A Kolkailah, Mina Iskander, Fady Iskander, Priya P Patel, Rozi Khan, Rami Doukky
• Journal: Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology (J Nucl Cardiol) Vol. 29 Issue 1 Pg. 101-110 (Feb 2022) ISSN: 1532-6551 [Electronic] United States
• PMID: 32632913 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2020. American Society of Nuclear Cardiology.

Chemical References

• Purines
• Pyrazoles
• regadenoson

Topics

• Adult
• Aged
• Exercise Test (methods)
• Female
• Humans
• Kidney Failure, Chronic (diagnostic imaging)
• Male
• Middle Aged
• Myocardial Perfusion Imaging (methods)
• Prognosis
• Purines
• Pyrazoles
• Retrospective Studies
• Tomography, Emission-Computed, Single-Photon (methods)