title: Prognostic study of cardiac and renal events in Japanese patients with chronic kidney disease and cardiovascular risk using myocardial perfusion SPECT: J-ACCESS 3 study design.
abstract: Cardiovascular disease is the leading cause of morbidity and mortality in patients with chronic kidney disease. Recent studies have indicated that the incidence of cardiovascular disease increases inversely with estimated glomerular filtration rate. Although coronary angiography is considered the gold standard for detecting coronary artery disease, contrast-induced nephropathy or cholesterol microembolization remain serious problems; therefore, a method of detecting coronary artery disease without renal deterioration is desirable. From this viewpoint, stress myocardial perfusion single photon emission computed tomography (SPECT) might be useful for patients with chronic kidney disease. We recently performed the Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS) investigating patients with suspected or extant coronary artery disease and the J-ACCESS 2 study of patients with diabetes. The findings from these studies showed that SPECT can detect coronary artery disease and help to predict future cardiac events. Thus, we proposed a multicenter, prospective cohort study called "J-ACCESS 3" in patients with chronic kidney disease and cardiovascular risk. The study aimed at predicting cardiovascular and renal events based on myocardial perfusion imaging and clinical backgrounds. We began enrolling patients in J-ACCESS 3 at 74 facilities from April 2009 and will continue to do so until 31 March 2010, with the aim of having a cohort of 800 patients. These will be followed up for three years. The primary endpoints will be cardiac death and sudden death. The secondary endpoints will comprise any cardiovascular or renal events. This study will be completed in 2013. Here, we describe the design of the J-ACCESS 3 study.
authors.affiliation: Department of Medicine, Division of Hypertension and Nephrology, National Cardiovascular Center, Suita, Japan.
authors.forename: Satoko
authors.initials: S
authors.lastname: Nakamura
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Kawano
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hase
authors.forename: Tsuguru
authors.initials: T
authors.lastname: Hatta
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Nishimura
authors.forename: Masao
authors.initials: M
authors.lastname: Moroi
authors.forename: Susumu
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Tokuo
authors.initials: T
authors.lastname: Kasai
authors.forename: Hideo
authors.initials: H
authors.lastname: Kusuoka
authors.forename: Yasuchika
authors.initials: Y
authors.lastname: Takeishi
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakajima
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Momose
authors.forename: Kazuya
authors.initials: K
authors.lastname: Takehana
authors.forename: Mamoru
authors.initials: M
authors.lastname: Nanasato
authors.forename: Syunichi
authors.initials: S
authors.lastname: Yoda
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Nishina
authors.forename: Naoya
authors.initials: N
authors.lastname: Matsumoto
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000209:etiology / Q000401:mortality; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000379:methods; D011379:Prognosis; D011446:Prospective Studies; D012107:Research Design; D012307:Risk Factors; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods*