Most Important Prognostic Values to Predict Major Adverse Cardiovascular, Cerebrovascular, and Renal Events in Patients with Chronic Kidney Disease Including Hemodialysis for 2 Years

Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular/cerebrovascular events. The aim of this study is to clarify whether stress myocardial perfusion single-photon emission computed tomography (SPECT) could predict cardiovascular/cerebrovascular events. In the Gunma-CKD SPECT Study, a multicenter prospective cohort trial, 311 patients with CKD (estimated glomerular filtration rate #x3c; 60 min/mL/1.73 m2) including 50 patients on hemodialysis underwent stress99mTc-tetrofosmin SPECT for suspected ischemic heart disease and were followed for 2 years. The primary endpoint was the occurrence of cardiac death (CD), while the secondary endpoint was major adverse cardiovascular/cerebrovascular and renal events (MACCRE). MACCRE occurred in 91 out of 286 patients (CD in 13 and other MACCRE in 78 patients). According to a multivariate Cox analysis, hemoglobin (Hb) and end-systolic volume (ESV) were associated with CD (p #x3c; 0.05), while the summed difference score, diabetes mellitus (DM), and Hb were associated with MACCRE (p #x3c; 0.05). Kaplan-Meier analysis showed that the CD-free rate was higher in patients with ESV #x3c; 105 mL (log-rank,p = 0.0013), Hb #x3e; 12 g (log-rank,p = 0.0036), and a summed stress score #x3c; 6 (log-rank,p = 0.0058). The MACCRE-free rate was higher in patients with SDS = 0 (log-rank,p = 0.0097), without DM (log-rank,p = 0.0091), and with Hb #x3e; 12 g (log-rank,p = 0.0023). Myocardial perfusion SPECT parameters as w...
Source: Cardiology - Category: Cardiology Source Type: research