Document Detail


Coronary computed tomography angiography in dialysis patients undergoing pre-renal transplantation cardiac risk stratification.
MedLine Citation:
PMID:  20690090     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: This study addresses the safety, feasibility, and interpretability of coronary computed tomography angiography (CCTA) in excluding significant coronary artery disease in end-stage renal disease patients on dialysis undergoing pre-renal transplant cardiac risk evaluation.
METHODS: Twenty nine patients (55.5 +/- 10.2 years) undergoing cardiac risk assessment prior to renal transplantation, underwent research CCTA with calcium scoring and formed the study group. All CCTAs were performed using retrospective acquisition, with beta-blockade provided one hour prior to scanning.
RESULTS: No major complications occurred in this group up to 30 days after CCTA. Of the total of 374 segments interpreted by both readers, only 36 (10%) were uninterpretable by both readers. Of these, 31 (86%) were from distal segments or branches. On a segmental level, there was 95% concordance between both readers for < 50% stenosis detection. Only three out of 28 (11%) CCTAs were deemed uninterpretable. Ten patients (36%) had zero calcium score, despite being on dialysis with no evidence of obstructive coronary artery disease by CCTA.
CONCLUSIONS: CCTA is feasible and safe in end-stage renal disease dialysis patients with the advent of 64-slice CCTA. Despite significant calcium burden, there was excellent inter-observer agreement at segment level for the left main and all three proximal-mid coronary arteries in excluding obstructive coronary artery disease (> 50% stenosis).
Authors:
Justin Mao; Vanji Karthikeyan; Chad Poopat; Thomas Song; Milan Pantelic; Joseph Chattahi; João L Cavalcante; Karthik Ananthasubramaniam
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  17     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-06     Completed Date:  2010-11-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  349-61     Citation Subset:  IM    
Affiliation:
Heart and Vascular Institute, Henry Ford Hospital, Detroit, MI 48202, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Chi-Square Distribution
Coronary Angiography / adverse effects,  methods*
Coronary Stenosis / complications,  radiography*,  ultrasonography
Echocardiography, Stress
Feasibility Studies
Female
Humans
Kidney Failure, Chronic / complications,  surgery,  therapy*
Kidney Transplantation* / adverse effects
Male
Michigan
Middle Aged
Observer Variation
Pilot Projects
Predictive Value of Tests
Preoperative Care
Prospective Studies
Renal Dialysis*
Reproducibility of Results
Risk Assessment
Risk Factors
Severity of Illness Index
Tomography, X-Ray Computed* / adverse effects
Comments/Corrections
Comment In:
Cardiol J. 2010;17(4):327-9   [PMID:  20690086 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Predictors of early graft patency following coronary artery bypass surgery.
Next Document:  Oxygen uptake efficiency slope correlates with brain natriuretic peptide in patients with heart fail...