Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017
Prognostic study of cardiac events in Japanese patients with chronic kidney disease using ECG-gated myocardial Perfusion imaging: Final 3-year report of the J-ACCESS 3 study.
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Nakamura Satoko, Kawano Yuhei, Nakajima Kenichi, Hase Hiroki, Joki Nobuhiko, Hatta Tsuguru, Nishimura Shigeyuki, Moroi Masao, Nakagawa Susumu, Kasai Tokuo, Kusuoka Hideo, Takeishi Yasuchika, Momose Mitsuru, Takehana Kazuya, Nanasato Mamoru, Yoda Syunichi, Nishina Hidetaka, Matsumoto Naoya, Nishimura Tsunehiko
Аннотация
BACKGROUND: Myocardial perfusion imaging (MPI) is considered useful for risk stratification among patients with chronic kidney disease (CKD), without renal deterioration by contrast media.
METHODS AND RESULTS: The Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients without a definitive coronary artery disease. All patients were assessed by stress and rest MPI with 99mTc-tetrofosmin and data were analyzed using a defect scoring method and QGS software. Major cardiac events were analyzed for 3 years after registration. The mean eGFR was 29.0 ± 12.8 (mL/minute/1.73 m2). The mean summed stress/rest/difference (SSS, SRS, SDS) scores were 1.9 ± 3.8, 1.1 ± 3.0, and 0.8 ± 1.8, respectively. A total of 60 cardiac events (three cardiac deaths, six sudden deaths, five nonfatal myocardial infarctions, 46 hospitalization cases for heart failure) occurred. The event-free survival rate was lower among patients with kidney dysfunction, higher SSS, and higher CRP values. Multivariate Cox regression analysis independently associated SSS ≥8, eGFR <15 (mL/minute/1.73 m2), and CRP ≥0.3 (mg/dL) with cardiac events.
CONCLUSIONS: Together with eGFR and CRP, MPI can predict cardiac events in patients with CKD.
METHODS AND RESULTS: The Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients without a definitive coronary artery disease. All patients were assessed by stress and rest MPI with 99mTc-tetrofosmin and data were analyzed using a defect scoring method and QGS software. Major cardiac events were analyzed for 3 years after registration. The mean eGFR was 29.0 ± 12.8 (mL/minute/1.73 m2). The mean summed stress/rest/difference (SSS, SRS, SDS) scores were 1.9 ± 3.8, 1.1 ± 3.0, and 0.8 ± 1.8, respectively. A total of 60 cardiac events (three cardiac deaths, six sudden deaths, five nonfatal myocardial infarctions, 46 hospitalization cases for heart failure) occurred. The event-free survival rate was lower among patients with kidney dysfunction, higher SSS, and higher CRP values. Multivariate Cox regression analysis independently associated SSS ≥8, eGFR <15 (mL/minute/1.73 m2), and CRP ≥0.3 (mg/dL) with cardiac events.
CONCLUSIONS: Together with eGFR and CRP, MPI can predict cardiac events in patients with CKD.
Предметные рубрики MeSH
AdultAgedAged, 80 and overContrast MediaDisease-Free SurvivalElectrocardiographyFemaleGlomerular Filtration RateHumansJapanKidney Failure, ChronicMaleMiddle AgedMultivariate AnalysisMyocardial InfarctionMyocardial Perfusion ImagingPrognosisProportional Hazards ModelsProspective StudiesRiskSoftwareTomography, Emission-Computed, Single-PhotonTreatment Outcome