Ahmed A Kolkailah1, Mina Iskander2, Fady Iskander2, Priya P Patel3, Rozi Khan4,5, Rami Doukky6,7,8,9. 1. Department of Medicine, Cook County Health, Chicago, IL, USA. 2. Division of Cardiology, Cook County Health, 1901 W. Harrison St, Chicago, IL, 60612, USA. 3. Department of Medicine, Rush University Medical Center, Chicago, IL, USA. 4. Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. 5. Department of Medicine, Medstar Union Memorial Hospital, Baltimore, MD, USA. 6. Department of Medicine, Cook County Health, Chicago, IL, USA. rdoukky@cookcountyhhs.org. 7. Division of Cardiology, Cook County Health, 1901 W. Harrison St, Chicago, IL, 60612, USA. rdoukky@cookcountyhhs.org. 8. Department of Medicine, Rush University Medical Center, Chicago, IL, USA. rdoukky@cookcountyhhs.org. 9. Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. rdoukky@cookcountyhhs.org.
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.
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: Ajoe John Kattoor; Ahmed A Kolkailah; Fady Iskander; Mina Iskander; Lisa Diep; Rozi Khan; Rami Doukky Journal: J Nucl Cardiol Date: 2020-05-07 Impact factor: 5.952
Authors: Aiden Abidov; Vasken Dilsizian; Rami Doukky; W Lane Duvall; Christopher Dyke; Michael D Elliott; Fadi G Hage; Milena J Henzlova; Nils P Johnson; Ronald G Schwartz; Gregory S Thomas; Andrew J Einstein Journal: J Nucl Cardiol Date: 2018-12-20 Impact factor: 5.952