Document Detail

The impact of chronic kidney disease as a predictor of major cardiac events in patients with no evidence of coronary artery disease.
MedLine Citation:
PMID:  20350504     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Normal stress myocardial perfusion images (MPI) generally show good prognosis for cardiovascular events. However, chronic kidney disease (CKD) is one of the important risk factors for coronary artery disease (CAD), and the interpretation of normal stress MPI has not been well established in CKD patients with no evidence of CAD. The purpose of this study was to evaluate the long-term prognostic value of stress MPI in CKD patients with no evidence of myocardial ischemia or infarction. METHODS: Patients who had no history but were suspected of CAD and had normal stress MPI (n=307, male=208, age=67 years, CKD/non-CKD=46/261) were followed-up for 4.5 years. CKD was defined as a glomerular filtration ratio of <60 ml/min/1.73 m(2) and/or persistent proteinuria. Cardiac death, non-fatal myocardial infarction, and unstable angina requiring hospitalization were defined as major cardiac events. RESULTS: Major cardiac events were observed in 3 of 261 (1.1%) non-CKD patients and 6 of 46 (13%) CKD patients (p<0.001, with log-rank test). CKD was an independent risk factor for major cardiac events (hazard ratio=13.1, p<0.001, multivariate Cox regression analysis). CONCLUSIONS: Normal stress MPI does not always promise a good prognosis for major cardiac events. Even in patients with no evidence of CAD from stress MPI, CKD can be an independent and significant risk factor for major cardiac events.
Tatsuhiko Furuhashi; Masao Moroi; Nobuhiko Joki; Hiroki Hase; Hirofumi Masai; Taeko Kunimasa; Ryo Nakazato; Hiroshi Fukuda; Kaoru Sugi
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Publication Detail:
Type:  Journal Article     Date:  2010-01-27
Journal Detail:
Title:  Journal of cardiology     Volume:  55     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-04-26     Completed Date:  2010-08-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  328-36     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-17-6 Ohashi, Meguro-ku, Tokyo 153-8515, Japan.
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MeSH Terms
Coronary Artery Disease / etiology*
Myocardial Perfusion Imaging* / methods
Renal Insufficiency, Chronic / complications*
Risk Factors

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