BACKGROUND: We performed a systematic review and meta-analysis to investigate the prognostic value of stress myocardial perfusion single-photon emission computed tomography (MPS) in predicting adverse cardiovascular events in patients with chronic kidney disease (CKD). METHODS: Studies published from inception until July 2020 were identified by PubMed and Embase databases search. Studies were included if they evaluated CKD patients referred for stress MPS, providing data on adjusted hazard ratio (HR) for the occurrence of adverse events. For studies providing only non-adjusted HR, the univariable risk estimate was included in the analysis. Pooled HR and 95% confidence interval (CI) were estimated using a random effects model to compare patients with abnormal and normal MPS. Whenever possible, incidence rate ratio (IRR) was also calculated and pooled. RESULTS: Sixteen eligible studies were identified including 7834 patients with a follow-up range from 1 to 4.4 years. Eleven articles included patients with end-stage renal disease (IV-V CKD stage), 3 articles with III-V CKD stage and 2 articles with I-V CKD stage. The pooled HR for the occurrence of adverse events was 2.02 (95% CI 1.68-2.42) and heterogeneity was 34%. Among the included studies, 5 reported the HR for the occurrence of hard events, with a pooled HR of 2.36 (95% CI 1.77-3.13). A total of 8 studies reported data useful to calculate the IRR in patients with normal and abnormal perfusion. The pooled IRR was 2.37 (95% CI 1.63-3.47) and heterogeneity was 60%. At meta-regression analysis, we found an association between HR for adverse events and age, hypertension and smoking, while no significant association was found between HR for hard events and demographic and clinical variables. CONCLUSIONS: In patients with CKD an abnormal myocardial perfusion at stress MPS is associated with adverse cardiovascular events.
BACKGROUND: We performed a systematic review and meta-analysis to investigate the prognostic value of stress myocardial perfusion single-photon emission computed tomography (MPS) in predicting adverse cardiovascular events in patients with chronic kidney disease (CKD). METHODS: Studies published from inception until July 2020 were identified by PubMed and Embase databases search. Studies were included if they evaluated CKD patients referred for stress MPS, providing data on adjusted hazard ratio (HR) for the occurrence of adverse events. For studies providing only non-adjusted HR, the univariable risk estimate was included in the analysis. Pooled HR and 95% confidence interval (CI) were estimated using a random effects model to compare patients with abnormal and normal MPS. Whenever possible, incidence rate ratio (IRR) was also calculated and pooled. RESULTS: Sixteen eligible studies were identified including 7834 patients with a follow-up range from 1 to 4.4 years. Eleven articles included patients with end-stage renal disease (IV-V CKD stage), 3 articles with III-V CKD stage and 2 articles with I-V CKD stage. The pooled HR for the occurrence of adverse events was 2.02 (95% CI 1.68-2.42) and heterogeneity was 34%. Among the included studies, 5 reported the HR for the occurrence of hard events, with a pooled HR of 2.36 (95% CI 1.77-3.13). A total of 8 studies reported data useful to calculate the IRR in patients with normal and abnormal perfusion. The pooled IRR was 2.37 (95% CI 1.63-3.47) and heterogeneity was 60%. At meta-regression analysis, we found an association between HR for adverse events and age, hypertension and smoking, while no significant association was found between HR for hard events and demographic and clinical variables. CONCLUSIONS: In patients with CKD an abnormal myocardial perfusion at stress MPS is associated with adverse cardiovascular events.
Authors: Salla Helve; Tuomo Nieminen; Ilkka Helanterä; Patrik Finne; Helena Rajala; Juha Sinisalo; Mika Laine Journal: Clin Transplant Date: 2020-05-22 Impact factor: 2.863
Authors: Simon Winther; My Svensson; Hanne Skou Jørgensen; Laust Dupont Rasmussen; Niels Ramsing Holm; Lars Christian Gormsen; Kirsten Bouchelouche; Hans Erik Bøtker; Per Ivarsen; Morten Bøttcher Journal: JACC Cardiovasc Imaging Date: 2017-09-13
Authors: Louis W Wang; Philip Masson; Robin M Turner; Stephen W Lord; Laura A Baines; Jonathan C Craig; Angela C Webster Journal: Transplantation Date: 2015-04 Impact factor: 4.939
Authors: Christian G Rabbat; Darin J Treleaven; J David Russell; David Ludwin; Deborah J Cook Journal: J Am Soc Nephrol Date: 2003-02 Impact factor: 10.121
Authors: Fadi G Hage; Stuart Smalheiser; Gilbert J Zoghbi; Gilbert J Perry; Mark Deierhoi; David Warnock; Ami E Iskandrian; Angelo M de Mattos; Raed A Aqel Journal: Am J Cardiol Date: 2007-07-05 Impact factor: 2.778
Authors: Mark J Sarnak; Kerstin Amann; Sripal Bangalore; João L Cavalcante; David M Charytan; Jonathan C Craig; John S Gill; Mark A Hlatky; Alan G Jardine; Ulf Landmesser; L Kristin Newby; Charles A Herzog; Michael Cheung; David C Wheeler; Wolfgang C Winkelmayer; Thomas H Marwick Journal: J Am Coll Cardiol Date: 2019-10-08 Impact factor: 24.094