Author + information
- William Edward Moodya,b,
- Erica Lai Sze Lina,b,
- Emer Changa,b,
- Nicola Edwardsa,b,
- Benjamin Hollowaya,b,
- Charles Ferroa,b,
- Jonathan Townenda,b and
- Richard Steedsa,b
Background: For patients awaiting renal transplantation, there is no guideline consensus on the need for repeat stress testing. Moreover, there are no serial data evaluating changes in ischemia.
Methods: 649 consecutive end-stage renal disease (ESRD) patients were referred for cardiovascular risk stratification prior to renal transplantation between 2007-13. Of these, 151 underwent two stress-rest 99mTc SPECT studies with CT attenuation in accordance with regional guidelines, which recommend repeat imaging in subjects who have not undergone transplantation within 3 years. Abnormal perfusion was defined as a summed stress score >=4.
Results: Table 1 shows the baseline characteristics for the study cohort.
The median interval between imaging was 48 months. At baseline, 28% of patients (42/151) had abnormal SPECT perfusion, half with a fixed defect. Of those 42 subjects, 60% continued to have an abnormal SPECT result at follow-up. Nine subjects (6%) with an ischemic perfusion defect size (PDS) >=10% underwent revascularization. In the 72% (109/151) with normal baseline perfusion, 19% (21/109) demonstrated new ischemia at follow-up, 3% (3/109) with an ischemic PDS >=10%. The development of ischemia was associated with systolic blood pressure (p=0.015), serum phosphate (p=0.043) and Agatston score (p=0.002) but not diabetes (p=0.120).
Conclusions: There is a high frequency of new-onset ischemia in ESRD patients awaiting renal transplant, supporting a need for repeat testing for risk stratification.
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: 1159-209
- 2017 American College of Cardiology Foundation