Role of Myocardial Perfusion Imaging in Patients With End-Stage Renal Disease Undergoing Coronary Angiography

Rajesh Venkataraman, Fadi G. Hage, Todd Dorfman, Jaekyeong Heo, Raed A. Aqel, Angelo M DeMattos, Ami E. Iskandrian

Research output: Contribution to journalArticle

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Abstract

Patients with end-stage renal disease (ESRD) are at high risk of cardiovascular events. This study examined the prognostic power of stress myocardial perfusion imaging (MPI) in 150 patients with ESRD (mean age 53 ± 9 years; 30% women; 66% with diabetes mellitus) being evaluated for renal transplantation with known coronary anatomy using angiography. Baseline data in addition to perfusion and angiographic parameters were compared between survivors and nonsurvivors. All-cause mortality was defined as the outcome measure. An abnormal MPI result was present in 85% of patients, 30% had left ventricular (LV) ejection fraction (EF) ≤40%, and 40% had multivessel coronary artery disease using angiography. At a mean follow-up of 3.4 ± 1.5 years, 53 patients died (35%). LVEF ≤40%, LV dilatation (LV end-diastolic volume >90 ml), and diabetes mellitus were associated with higher mortality (all p <0.05). Both total perfusion defect size and mean number of narrowed coronary arteries using angiography were significantly higher in those who died (p <0.05). In a multivariate model, abnormal MPI results (low LVEF or abnormal perfusion) and diabetes alone were independent predictors of death, whereas number of narrowed arteries using coronary angiography was not. Thus, MPI was a strong predictor of all-cause mortality in patients with ESRD. In conclusion, abnormal MPI results independently predicted worse survival and provided more powerful prognostic data than coronary angiography.

Original languageEnglish (US)
Pages (from-to)1451-1456
Number of pages6
JournalAmerican Journal of Cardiology
Volume102
Issue number11
DOIs
StatePublished - Dec 1 2008

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Myocardial Perfusion Imaging
Coronary Angiography
Chronic Kidney Failure
Angiography
Perfusion
Stroke Volume
Mortality
Diabetes Mellitus
Kidney Transplantation
Survivors
Coronary Artery Disease
Dilatation
Anatomy
Coronary Vessels
Arteries
Outcome Assessment (Health Care)
Survival

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Role of Myocardial Perfusion Imaging in Patients With End-Stage Renal Disease Undergoing Coronary Angiography. / Venkataraman, Rajesh; Hage, Fadi G.; Dorfman, Todd; Heo, Jaekyeong; Aqel, Raed A.; DeMattos, Angelo M; Iskandrian, Ami E.

In: American Journal of Cardiology, Vol. 102, No. 11, 01.12.2008, p. 1451-1456.

Research output: Contribution to journalArticle

Venkataraman, Rajesh ; Hage, Fadi G. ; Dorfman, Todd ; Heo, Jaekyeong ; Aqel, Raed A. ; DeMattos, Angelo M ; Iskandrian, Ami E. / Role of Myocardial Perfusion Imaging in Patients With End-Stage Renal Disease Undergoing Coronary Angiography. In: American Journal of Cardiology. 2008 ; Vol. 102, No. 11. pp. 1451-1456.
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