Risk Factors Associated With New-Onset Myocardial Perfusion Abnormalities in Kidney Transplant Candidates
Section snippets
Methods
We identified patients awaiting kidney transplantation who underwent 2 MPI studies (single-photon emission computed tomography [SPECT] or positron emission tomography) at Emory University Hospital between January 2010 and December 2019 (n = 709). According to the Emory University Hospital protocol, patients who underwent evaluation for potential kidney transplantation are referred for noninvasive cardiovascular risk assessment using technetium-99m SPECT if they fulfilled any of the following
Results
A total of 709 patients underwent serial MPI study performed between January 2010 and December 2019. The baseline characteristics of the cohort are listed in Table 1. The mean age was 52 years, with 59% being male, 35% with a history of diabetes mellitus, 63% with a history of hypertension, and 5% with a history of previous MI. The mean time interval between images was 3.4±1.7 years. On initial imaging, 12% (86 of 709) of patients had a perfusion defect (fixed or reversible). Of the 86 patients
Discussion
This retrospective cohort study of patients with ESRD awaiting kidney transplantation found that 10% of patients developed new-onset myocardial perfusion defect over a mean time interval of 3.4 years and that only 2% developed moderate-severe ischemia. Male gender, a history of MI, and PAD are independent risk factors for developing new perfusion defects. Those with a history of MI were also more likely to develop moderate-severe ischemia. Women appear to be at lower risk of developing both new
Disclosures
The authors have no conflicts of interest to declare.
References (21)
- et al.
Acute coronary syndromes after renal transplantation in patients with end-stage renal disease resulting from diabetes
Am J Transplant
(2002) - et al.
Birmingham Cardio-Renal Group. Results of serial myocardial perfusion imaging in end-stage renal disease
Am J Cardiol
(2018) - et al.
Prognostic value of risk factors, calcium score, coronary CTA, myocardial perfusion imaging, and invasive coronary angiography in kidney transplantation candidates
JACC Cardiovasc Imaging
(2018) - et al.
Cardiac troponins and chronic kidney disease
Kidney Int
(2006) - et al.
A clinical randomized trial to evaluate the safety of a noninvasive approach in high-risk patients undergoing major vascular surgery: the DECREASE-V Pilot Study
J Am Coll Cardiol
(2007) The argument for abolishing cardiac screening of asymptomatic kidney transplant candidates
Am J Kidney Dis
(2020)- et al.
Acute myocardial infarction and kidney transplantation
J Am Soc Nephrol
(2006) - et al.
Graft loss and acute coronary syndromes after renal transplantation in the United States
J Am Soc Nephrol
(2002) - et al.
Incidence and predictors of myocardial infarction after kidney transplantation
J Am Soc Nephrol
(2005) - et al.
Poor long-term survival after acute myocardial infarction among patients on long-term dialysis
N Engl J Med
(1998)