title: Impact of chronic kidney disease and stress myocardial perfusion imaging as a predictor of cardiovascular events.
abstract: BACKGROUND
  Stress myocardial perfusion imaging (MPI) is an established means of predicting cardiovascular events and is suitable in chronic kidney disease (CKD) patients. We aimed to evaluate the prognostic value of CKD parameters and an abnormal stress MPI for cardiovascular events.
  
  
  METHODS
  A total of 495 patients with suspected coronary artery disease (CAD) or history of CAD including 130 CKD patients not undergoing hemodialysis, underwent stress MPI (313 males, mean age 70 years) and were followed up for 14 months (mean period). CKD was defined as an estimated GFR of <60 ml/min/1.73 m(2) and/or persistent proteinuria. Cardiovascular events were defined as sudden cardiac death, acute coronary syndrome and congestive heart failure requiring hospitalization.
  
  
  RESULTS
  Cardiovascular events occurred in 41 (8.3%) patients. Multivariate Cox regression analysis indicated that CKD [hazard ratio (HR) = 3.76, p < 0.001] and a stress MPI summed difference score (SDS) of ≥2 (HR = 3.78, p < 0.001) were independent predictors of cardiovascular events; CKD plus abnormal stress MPI was also a strong predictor of cardiovascular events (non-CKD and SDS <2 vs. CKD and SDS ≥2, HR = 15.9, p < 0.001).
  
  
  CONCLUSIONS
  Both CKD and myocardial ischemia detected by stress MPI are independent predictors for cardiovascular events. Coexistence of CKD and myocardial ischemia detected by stress MPI is more useful for short-term risk stratification of cardiovascular events.
authors: Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
authors: Tatsuhiko
authors: T
authors: Furuhashi
authors: Masao
authors: M
authors: Moroi
authors: Nobuhiko
authors: N
authors: Joki
authors: Hiroki
authors: H
authors: Hase
authors: Hirofumi
authors: H
authors: Masai
authors: Taeko
authors: T
authors: Kunimasa
authors: Ryo
authors: R
authors: Nakazato
authors: Hiroshi
authors: H
authors: Fukuda
authors: Kaoru
authors: K
authors: Sugi
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D002908:Chronic Disease; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D007674:Kidney Diseases / Q000150:complications*; D008297:Male; D055414:Myocardial Perfusion Imaging; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D013312:Stress, Physiological; D013794:Thallium Radioisotopes
chemical_list: D013794:Thallium Radioisotopes