title: Predicting cardiac events with Tl201 dipyridamole myocardial scintigraphy in renal transplant recipients.
abstract: BACKGROUND
  Renal transplant recipients should be screened for coronary artery disease. The purpose of this study was to evaluate the usefulness of thallium-201 dipyridamole myocardial perfusion single-photon emission computed tomography (SPECT) to predict major cardiac events in these patients.
  
  
  RESULTS
  Eighty-two consecutive patients (61 males) in hemodialysis (HD) treatment, awaiting renal transplantation, underwent dipyridamole Tl-201 SPECT for pretransplant risk stratification. SPECT semiquantitative analysis showed a normal perfusion pattern in 52 patients (group A) and fixed defects in 9 (group B). Reversible perfusion defects were found in 21 (group C). Cardiac death, myocadial infarction, and unstable angina were sought as cardiac events. During a follow-up lasting 28.3 +/- 21.6 months, three patients of group A died for a non-cardiac cause. In group C, six patients (28.6%) had a cadiac event: one had a non-q wave myocardial infarction after renal transplantation; five were admitted with unstable angina. No cardiac events were observed in groups A and B (p = 0.0001). SPECT semiquantitative analysis showed that a summed difference score > or = 3 significantly increased the risk of cardiac events (odds ratio 4.5, C.I. 2.5-8.1).
  
  
  CONCLUSIONS
  Cardiac events were only observed in HD patients with Tl-201 SPECT dipyridamole reversible defects (group C). A normal pattern or a fixed defect in Tl-201 dipyridamole SPECT in HD patients identified a good long-term prognosis.
authors.affiliation: Department of Cardiology, Service of Nuclear Medicine, Santa Croce-Carle Hospital, Cuneo, Italy. feola@isiline.it
authors.forename: Mauro
authors.initials: M
authors.lastname: Feola
authors.forename: Alberto
authors.initials: A
authors.lastname: Biggi
authors.forename: Flavio
authors.initials: F
authors.lastname: Ribichini
authors.forename: Alba
authors.initials: A
authors.lastname: Rovere
authors.forename: Antonello
authors.initials: A
authors.lastname: Vado
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Camuzzini
authors.forename: Eugenio
authors.initials: E
authors.lastname: Uslenghi
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D006435:Renal Dialysis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013794:Thallium Radioisotopes; D015899:Tomography, Emission-Computed, Single-Photon
chemical_list: D013794:Thallium Radioisotopes