title: Cardiac event risk in Japanese subjects estimated using gated myocardial perfusion imaging, in conjunction with diabetes mellitus and chronic kidney disease.
abstract: BACKGROUND
  Cardiac event risk is estimated using quantitative gated myocardial perfusion imaging (MPI) and clinical background in patients with ischemic heart disease. The aim of the present study was to calculate major cardiac event risk and tabulate it in the Heart Risk Table for clinical use of risk stratification.
  
  
  RESULTS
  Multivariate logistic regression was performed based on a multicenter prognostic database (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated Single-photon emission computed tomography [J-ACCESS investigation]) using MPI (n=2,395). The risk of major cardiac events (cardiac death, non-fatal myocardial infarction and heart failure requiring hospitalization) was estimated using age, ejection fraction (EF), estimated glomerular filtration rate (eGFR) and presence of diabetes mellitus (DM). Age-matched standard eGFR was determined in 77 subjects. Major cardiac event risk was calculated using the equation: risk (%/3 years)=1/(1+Exp(-(-4.699-0.0151×eGFR+0.7998×DM+0.0582×age+0.697×SSS-0.0359×EF))×100, where SSS refers to summed stress scores. Risk was determined without eGFR (the initial version) and using the present formula with eGFR (revised version), with consistent results. DM and chronic kidney disease were major determinants of cardiac events.
  
  
  CONCLUSIONS
  Cardiac event risk was estimated using MPI defect score and left ventricular EF in conjunction with eGFR and the presence of DM. The risk table might be used for risk evaluation in Japanese patients undergoing MPI.
authors: Department of Nuclear Medicine, Kanazawa University Hospital, Kanazawa, Japan. nakaijma@med.kanazawa-u.ac.jp
authors: Kenichi
authors: K
authors: Nakajima
authors: Shinro
authors: S
authors: Matsuo
authors: Chio
authors: C
authors: Okuyama
authors: Tsuguru
authors: T
authors: Hatta
authors: Kazumasa
authors: K
authors: Tsukamoto
authors: Shigeyuki
authors: S
authors: Nishimura
authors: Akira
authors: A
authors: Yamashina
authors: Hideo
authors: H
authors: Kusuoka
authors: Tsunehiko
authors: T
authors: Nishimura
mesh_terms: D000368:Aged; D044466:Asian People / Q000208:ethnology; D002908:Chronic Disease; D016208:Databases, Factual; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D048909:Diabetes Complications / Q000150:complications* / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000502:physiology; D006333:Heart Failure / Q000453:epidemiology; D006801:Humans; D007564:Japan; D007674:Kidney Diseases / Q000150:complications* / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D017202:Myocardial Ischemia / Q000150:complications* / Q000000981:diagnostic imaging* / Q000208:ethnology; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology