The value of myocardial perfusion imaging in screening coronary artery disease before kidney transplantation

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Helve , S , Nieminen , T , Helanterä , I , Finne , P , Rajala , H , Sinisalo , J & Laine , M 2020 , ' The value of myocardial perfusion imaging in screening coronary artery disease before kidney transplantation ' , Clinical Transplantation , vol. 34 , no. 8 , 13894 . https://doi.org/10.1111/ctr.13894

Title: The value of myocardial perfusion imaging in screening coronary artery disease before kidney transplantation
Author: Helve, Salla; Nieminen, Tuomo; Helanterä, Ilkka; Finne, Patrik; Rajala, Helena; Sinisalo, Juha; Laine, Mika
Other contributor: University of Helsinki, Kardiologian yksikkö
University of Helsinki, HUS Internal Medicine and Rehabilitation
University of Helsinki, HUS Abdominal Center
University of Helsinki, Department of Medicine
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Heart and Lung Center
University of Helsinki, HUS Heart and Lung Center












Date: 2020-08
Language: eng
Number of pages: 8
Belongs to series: Clinical Transplantation
ISSN: 0902-0063
DOI: https://doi.org/10.1111/ctr.13894
URI: http://hdl.handle.net/10138/329608
Abstract: Abstract The value of myocardial single-photon emission computed tomography (SPECT) in pre-transplant evaluation of kidney transplant recipients is controversial. We assessed whether myocardial SPECT predicts major adverse cardiac events (MACE) and determined whether SPECT findings affected transplant recipients? medical and invasive treatment. We analyzed 301 patients referred for myocardial SPECT before kidney transplantation and combined the results with information from patient files and the Transplantation registry. During the median follow-up time of 96 months (IQR 70.75-118.25 months), the incidence of MACE was higher in patients (n=37) with severely abnormal SPECT (>10 % reversible perfusion defect) than in patients (n=35) with mildly abnormal or normal SPECT (51.4%, 29.4% and 27.0%, respectively, p=0.011). Severely abnormal SPECT findings predicted long-term MACE in a univariable analysis but not after adjusting for other risk factors. Following SPECT, 29 patients (9.6%) underwent coronary angiography and 14 (4.6%) were revascularized. New antithrombotic or statin medication was prescribed to 7.3% of patients with ischemia in SPECT. Kidney transplantation patients are at high long-term risk of MACE even with normal preoperative myocardial SPECT. Abnormal SPECT did not predict MACE when adjusted for other risk factors. Minority of the patients underwent coronary revascularization or had changes in preventive medication before transplantation.
Subject: 3121 General medicine, internal medicine and other clinical medicine
cardiovascular disease
kidney transplantation
myocardial perfusion imaging
REVASCULARIZATION
SCINTIGRAPHY
RISK
DEATH
RECIPIENTS
PROGNOSTIC VALUE
MEDICAL THERAPY
COLLEGE
TERM SURVIVAL
CARDIOVASCULAR-DISEASE
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