Prognostic study of cardiac events in Japanese patients with chronic kidney disease using ECG-gated myocardial Perfusion imaging: Final 3-year report of the J-ACCESS 3 study

Journal Article · Mon Apr 15 04:00:00 EDT 2019 · Journal of Nuclear Cardiology (Online)

DOI:https://doi.org/10.1007/S12350-017-0880-5· OSTI ID:22962103

Nakamura, Satoko; Kawano, Yuhei ^[1]; Nakajima, Kenichi ^[2]; Hase, Hiroki; Joki, Nobuhiko ^[3]; Hatta, Tsuguru ^[4]; Nishimura, Shigeyuki ^[5]; Moroi, Masao ^[6]; Nakagawa, Susumu ^[7]; Kasai, Tokuo ^[8]; Kusuoka, Hideo ^[9]; Takeishi, Yasuchika ^[10]; Momose, Mitsuru ^[11]; Takehana, Kazuya ^[12]; Nanasato, Mamoru ^[13]; Yoda, Syunichi ^[14]; Nishina, Hidetaka ^[15]; Matsumoto, Naoya ^[16]; Nishimura, Tsunehiko ^[17]

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1. National Cerebral and Cardiovascular Center, Division of Hypertension and Nephrology (Japan)
2. Kanazawa University Hospital, Department of Nuclear Medicine (Japan)
3. Toho University Ohashi Medical Center, Department of Nephrology (Japan)
4. Ohmihachiman Community Medical Center, Division of Nephrology, Department of Medicine (Japan)
5. Saitama Medical University International Medical Center (Japan)
6. Toho University Ohashi Medical Center, Department of Cardiology (Japan)
7. Saiseikai Central Hospital, Department of Cardiology (Japan)
8. Jikei Medical University Aoto Hospital, Department of Cardiology (Japan)
9. National Hospital Organization Osaka National Hospital (Japan)
10. Fukushima Medical University, Department of Medicine (Japan)
11. Tokyo Women’s Medical University, Department of Radiology (Japan)
12. Kansai Medical University, Department of Cardiology (Japan)
13. Nagoya Daini Red-Cross Hospital, Department of Cardiology (Japan)
14. Nihon University Itabashi Hospital, Department of Cardiology (Japan)
15. Tsukuba Medical Center Hospital, Department of Cardiology (Japan)
16. Suruga-dai Nihon University Hospital, Department of Cardiology (Japan)
17. Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan)

Background: Myocardial perfusion imaging (MPI) is considered useful for risk stratification among patients with chronic kidney disease (CKD), without renal deterioration by contrast media. Methods and Results: The Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients without a definitive coronary artery disease. All patients were assessed by stress and rest MPI with {sup 99m}Tc-tetrofosmin and data were analyzed using a defect scoring method and QGS software. Major cardiac events were analyzed for 3 years after registration. The mean eGFR was 29.0 ± 12.8 (mL/minute/1.73 m{sup 2}). The mean summed stress/rest/difference (SSS, SRS, SDS) scores were 1.9 ± 3.8, 1.1 ± 3.0, and 0.8 ± 1.8, respectively. A total of 60 cardiac events (three cardiac deaths, six sudden deaths, five nonfatal myocardial infarctions, 46 hospitalization cases for heart failure) occurred. The event-free survival rate was lower among patients with kidney dysfunction, higher SSS, and higher CRP values. Multivariate Cox regression analysis independently associated SSS ≥8, eGFR <15 (mL/minute/1.73 m{sup 2}), and CRP ≥0.3 (mg/dL) with cardiac events. Conclusions: Together with eGFR and CRP, MPI can predict cardiac events in patients with CKD.

• OSTI ID: 22962103
• Journal Information: Journal of Nuclear Cardiology (Online), Journal Name: Journal of Nuclear Cardiology (Online) Journal Issue: 2 Vol. 26; ISSN 1532-6551
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CONTRAST MEDIA
CORONARIES
DISEASE INCIDENCE
HAZARDS
HEART FAILURE
KIDNEYS
MYOCARDIAL INFARCTION
PATIENTS
REGRESSION ANALYSIS
SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY
TECHNETIUM 99