Author + information
- Chiedozie Anokwute,
- Ibtihaj Fughhi,
- Marwan Wassouf,
- Michael Kharouta,
- Tania Campagnoli,
- Aviral Vij,
- George Khoudary,
- Rozi Khan,
- Meron Teshome,
- Andrew Appis and
- Rami Doukky
Background: The role of serial SPECT myocardial perfusion imaging (MPI) for CAD surveillance in asymptomatic ESRD patients awaiting kidney transplantation (KT) is controversial.
Methods: In a prospective cohort study, we analyzed consecutive asymptomatic KT candidates who had 2 MPI studies within 5 years prior to KT or end of follow up. Worsening MPI was defined as an increase in quantitatively measured total perfusion deficit (ΔTPD) > 5%. High clinical risk was defined as ≥3 KT risk factors set forth by AHA/ACCF statement (age > 60 y, HTN, DM, dyslipidemia, smoking, cardiovascular disease, dialysis > 1 y, LVH). The outcome was a composite of death or MI (D/MI).
Results: Among 656 KT candidates with serial MPI (mean interval 19 ± 11 months); 44% had normal initial MPI and 11% had ΔTPD > 5% on repeat MPI. Incidence of ΔTPD > 5% increased with increasing time gap between serial MPIs (Fig 1). There were 221 (34%) events of D/Ml. ΔTPD > 5% was associated with increased risk of D/MI (Fig 2), even after adjusting for TPD on the initial MPI and the sum of risk factors (HR, 1.70; CI, 1.16-2.49; P = 0.007). ΔTPD > 5% was associated with increased risk of D/MI in patients with initial normal or abnormal MPI (Fig 3). ΔTPD > 5% was associated with increased risk of D/MI in patients with ≥3 risk factors, but not among those with ≤2 risk factors (Fig 4).
Conclusions: These data support serial MPI testing in high risk KT candidates (≥3 risk factors), irrespective of initial MPI findings. Role of coronary revascularization in this context is unknown.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Nuclear Cardiology: Prognosis
Abstract Category: 30. Non Invasive Imaging: Nuclear
Presentation Number: 1159-207
- 2017 American College of Cardiology Foundation