Journal of Nuclear Cardiology

, Volume 24, Issue 1, pp 112–118 | Cite as

The prognostic value of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease

  • Rami Doukky
  • Ibtihaj Fughhi
  • Tania Campagnoli
  • Marwan Wassouf
  • Amjad Ali
Original Article

Abstract

Background

The prognostic value of regadenoson SPECT myocardial perfusion imaging (MPI) has not been specifically studied in patients with end-stage renal disease (ESRD).

Methods and Results

We prospectively followed ESRD patients enrolled in the ASSUAGE and ASSUAGE-CKD trials in which they received regadenoson-stress 99mTc-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).

Conclusion

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.

Keywords

Regadenoson myocardial perfusion imaging (MPI) end-stage renal disease (ESRD) coronary artery disease prognosis outcome 

Abbreviations

CAD

Coronary artery disease

CR

Coronary revascularization

ESRD

End-stage renal disease

LV

Left ventricular

MI

Myocardial infarction

MPI

Myocardial perfusion abnormality

SDS

Summed difference score

SPECT

Single-photon emission computed tomography

SSS

Summed stress score

TID

Transient ischemic dilation

Notes

Disclosure

Rami Doukky serves on the Advisory Board for Astellas Pharma and receives research funding from Astellas Pharma. Other authors have no conflicts to report.

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Copyright information

© American Society of Nuclear Cardiology 2015

Authors and Affiliations

  • Rami Doukky
    • 1
    • 2
  • Ibtihaj Fughhi
    • 2
  • Tania Campagnoli
    • 2
  • Marwan Wassouf
    • 2
  • Amjad Ali
    • 3
  1. 1.Division of CardiologyJohn H. Stroger, Jr. Hospital of Cook CountyChicagoUSA
  2. 2.Division of CardiologyRush University Medical CenterChicagoUSA
  3. 3.Department of Radiology and Nuclear MedicineRush University Medical CenterChicagoUSA

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