title: Real-time myocardial contrast echocardiography as a useful tool to select candidates for coronary revascularization among patients with end-stage renal disease - a 3-year follow-up study.
abstract: OBJECTIVE
  To evaluate a real-time myocardial contrast echocardiography (MCE) as a tool to select candidates for coronary revascularization among patients with ESRD and to assess the rate of revascularization and mortality.
  
  
  METHODS
  58 ESRD patients were screened for CAD using MCE. We analyzed the rate of coronary revascularization during 3-year follow-up. Patients with and without perfusion disturbances on MCE were compared.
  
  
  RESULTS
  CAD was found in 46.2% patients out of 39 who underwent coronary angiography. 11 (39.3%) patients out of 28 from the group with perfusion defects on MCE underwent revascularization procedure (21.4% - PCI, 17.9% - CABG). No one from the group without perfusion defects had revascularization procedure. Perfusion defect (OR 1.37 CI 1.37-1.86, p=0.022) was related to revascularization in multivariant analysis (OR 12.87, CI 1.86-89.21, p=0.025). There was no difference in mortality between the group which underwent invasive procedures and treated conservatively (p=0.6643). In ROC analysis defects on MCE and CAD on angiography were equally good in anticipating combined end-point (AUC 0.716, CI 95% 0.544-0.851 and AUC 0.747, CI 95% 0.577-0.875, p=0.701) and death (AUC 0.752, CI 95% 0.582-0.878 and AUC 0.729, CI 95% 0.558-0.861, p=0.805).
  
  
  CONCLUSIONS
  Our results indicate that MCE is a safe and uncomplicated method which may help along with other methods to select candidates for coronary revascularization among ESRD patients. In our study coronary revascularization procedures were successful but they did not improve patients' survival on 3-year follow-up.
authors: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland. walkaz@poczta.fm
authors: A
authors: A
authors: Tomaszuk-Kazberuk
authors: B
authors: B
authors: Sobkowicz
authors: J
authors: J
authors: Malyszko
authors: J S
authors: JS
authors: Malyszko
authors: T
authors: T
authors: Hirnle
authors: S
authors: S
authors: Dobrzycki
authors: M
authors: M
authors: Mysliwiec
authors: W J
authors: WJ
authors: Musial
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D019540:Area Under Curve; D003287:Contrast Media / Q000494:pharmacology; D017023:Coronary Angiography / Q000379:methods; D004452:Echocardiography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009204:Myocardial Revascularization; D010477:Perfusion; D012372:ROC Curve
chemical_list: D003287:Contrast Media