title: The prognostic value of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease.
abstract: The prognostic value of regadenoson SPECT myocardial perfusion imaging (MPI) has not been specifically studied in patients with end-stage renal disease (ESRD).
  
  
  
  We prospectively followed ESRD patients enrolled in the ASSUAGE and ASSUAGE-CKD trials in which they received regadenoson-stress99mTc-tetrofosmin SPECT-MPI. Images were semiquantitatively analyzed by an investigator blinded to clinical and outcome data. Patients were followed for cardiac death, myocardial infarction (MI), and coronary revascularization (CR). Revascularizations occurring >90 days post-MPI were considered "late" events. Survival analysis was performed using Cox regression models, adjusting for age, gender, diabetes, dyslipidemia, smoking, and known coronary artery disease. We analyzed 303 patients (mean age 54 years; 64% men), who were followed for 35 ± 10 months. Adjusting for clinical covariates, abnormal regadenoson-stress MPI (SSS ≥ 4) was associated with increased risk of the composite of cardiac death or MI (23.9% vs 14.4%; HR 1.88; CI 1.04-3.41; P = .037) and the composite of cardiac death, MI, or late CR (27.3% vs 16.7%; HR 1.80; CI 1.03-3.14; P = .039). Adjusting for clinical covariates, regadenoson-induced myocardial ischemia (SDS ≥ 2) was associated with increased rate of the composite endpoint of cardiac death, MI, or CR (33.3% vs 16.9%; HR 1.97; CI 1.19-3.27; P = .008).
  
  
  
  Regadenoson-stress SPECT-MPI provides a significant prognostic value in patients with ESRD. ESRD patients with normal SPECT-MPI have relatively high adverse event rates.
authors.affiliation: Division of Cardiology, John H. Stroger, Jr. Hospital of Cook County, 1901 W. Harrison St., Suite # 3620, Chicago, IL, 60612, USA. rami_doukky@rush.edu.|Division of Cardiology, Rush University Medical Center, Chicago, IL, USA. rami_doukky@rush.edu.
authors.forename: Rami
authors.initials: R
authors.lastname: Doukky
authors.affiliation: Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Ibtihaj
authors.initials: I
authors.lastname: Fughhi
authors.affiliation: Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Tania
authors.initials: T
authors.lastname: Campagnoli
authors.affiliation: Division of Cardiology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Marwan
authors.initials: M
authors.lastname: Wassouf
authors.affiliation: Department of Radiology and Nuclear Medicine, Rush University Medical Center, Chicago, IL, USA.
authors.forename: Amjad
authors.initials: A
authors.lastname: Ali
mesh_terms: D017677:Age Distribution; D059347:Cardio-Renal Syndrome / Q000000981:diagnostic imaging / Q000401:mortality*; D002641:Chicago / Q000453:epidemiology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D016757:Death, Sudden, Cardiac / Q000453:epidemiology*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D007676:Kidney Failure, Chronic / Q000000981:diagnostic imaging / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging / Q000379:methods / Q000706:statistics & numerical data*; D011379:Prognosis; D011687:Purines; D011720:Pyrazoles; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D016037:Single-Blind Method; D015996:Survival Rate; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods / Q000706:statistics & numerical data; D014665:Vasodilator Agents
chemical_list: D011687:Purines; D011720:Pyrazoles; D014665:Vasodilator Agents; C430916:regadenoson
keywords: Regadenoson; coronary artery disease; end-stage renal disease (ESRD); myocardial perfusion imaging (MPI); outcome; prognosis