Skip Navigation



NDT Advance Access published online on February 19, 2004
Nephrology Dialysis Transplantation, doi:10.1093/ndt/gfh037
© 2004 by European Renal Association - European Dialysis and Transplant Association
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
19/5/1161    most recent
gfh037v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Hase, H.
Right arrow Articles by Moroi, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Hase, H.
Right arrow Articles by Moroi, M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Received July 7, 2003
Accepted November 20, 2003

Original Article

Prognostic value of stress myocardial perfusion imaging using adenosine triphosphate at the beginning of haemodialysis treatment in patients with end-stage renal disease

Hiroki Hase 1*, Nobuhiko Joki 1, Hiroyasu Ishikawa 1, Hiroshi Fukuda 2, Yoshihiko Imamura 3, Tomokatsu Saijyo 1, Yuri Tanaka 1, Yasunori Takahashi 1, Yoji Inishi 1, Masato Nakamura 2, Masao Moroi 2

1 Division of Nephrology, Department of Internal Medicine, Toho University Ohashi Hospital, Tokyo, Japan
2 Division of Cardiology, Department of Internal Medicine, Toho University Ohashi Hospital, Tokyo, Japan
3 Division of Dialysis and Nephrology, Nissan Tamagawa Hospital, Tokyo, Japan

* To whom correspondence should be addressed. E-mail: hiroki{at}oha.toho-u.ac.jp.



  Abstract

Background. Non-invasive detection of coronary artery disease (CAD) remains difficult in patients with end-stage renal disease (ESRD). This study evaluated the ability of pharmacologic stress myocardial perfusion imaging to predict cardiac events in patients with ESRD.

Methods. A prospective study was carried out in 49 consecutive patients with ESRD. Thallium-201 single photon emission computed tomography (SPECT) using high-dose adenosine triphosphate (ATP) was performed within 1 month of the beginning of haemodialysis. The study end-point was a cardiac event or the 1-year anniversary of the SPECT study.

Results. Twenty-four patients (17 diabetics, 57% and seven non-diabetics, 37%) had myocardial perfusion defects. The remaining 25 patients had normal perfusion images. Fifteen patients had non-fatal cardiac events and two patients died of a cardiac cause. All patients who had non-fatal cardiac events underwent myocardial revascularization and survived until the end of follow-up. The 1-year cardiac event-free survival rate was 34% among patients with perfusion defects and 96% among patients without perfusion defects (P<0.001). The presence of a myocardial perfusion defect was the only independent predictor of 1-year cardiac events both in overall (HR, 49.91; 95% CI, 5.15-484.00; P<0.001) and in diabetic patients (HR, 33.72; 95% CI, 2.96-383.5; P = 0.005). Diabetes and an increased C-reactive protein were associated with the progression of CAD.

Conclusions. Normal myocardial perfusion imaging by stress thallium-201 SPECT using high-dose ATP performed within 1 month after the beginning of haemodialysis treatment is a powerful predictor of cardiac event-free survival in patients with ESRD.

Keywords: cardiovascular mortality; coronary artery disease; end-stage renal disease; outcome; percutaneous transluminal coronary angioplasty; prospective cohort study; scintigraphic uptake


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
A. Hakeem, S. Bhatti, K. S. Dillie, J. R. Cook, Z. Samad, M. D. Roth-Cline, and S. M. Chang
Predictive Value of Myocardial Perfusion Single-Photon Emission Computed Tomography and the Impact of Renal Function on Cardiac Death
Circulation, December 9, 2008; 118(24): 2540 - 2549.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. Nishimura, K. Tsukamoto, N. Hasebe, N. Tamaki, K. Kikuchi, and T. Ono
Prediction of Cardiac Death in Hemodialysis Patients by Myocardial Fatty Acid Imaging
J. Am. Coll. Cardiol., January 15, 2008; 51(2): 139 - 145.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
Y. Tanaka, N. Joki, and H. Hase
History of acute coronary events during the predialysis phase of chronic kidney disease is a strong risk factor for major adverse cardiac events in patients initiating haemodialysis
Nephrol. Dial. Transplant., October 1, 2007; 22(10): 2917 - 2923.
[Abstract] [Full Text] [PDF]

Home page
 Nephrol Dial TransplantHome page
N. Joki, H. Hase, Y. Tanaka, Y. Takahashi, T. Saijyo, H. Ishikawa, Y. Inishi, Y. Imamura, H. Hara, T. Tsunoda, et al.
Relationship between serum albumin level before initiating haemodialysis and angiographic severity of coronary atherosclerosis in end-stage renal disease patients
Nephrol. Dial. Transplant., June 1, 2006; 21(6): 1633 - 1639.
[Abstract] [Full Text] [PDF]

Home page
 Pharmacol. Rev.Home page
G. Burnstock
Pathophysiology and therapeutic potential of purinergic signaling.
Pharmacol. Rev., March 1, 2006; 58(1): 58 - 86.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.