Prognostic study of cardiac events in Japanese patients with chronic kidney disease using ECG-gated myocardial Perfusion imaging: Final 3-year report of the J-ACCESS 3 study

• Published in: Journal of nuclear cardiology 2019-04, Vol.26 (2), p.431-440
• Main Authors: Nakamura, Satoko, Kawano, Yuhei, Nakajima, Kenichi, Hase, Hiroki, Joki, Nobuhiko, Hatta, Tsuguru, Nishimura, Shigeyuki, Moroi, Masao, Nakagawa, Susumu, Kasai, Tokuo, Kusuoka, Hideo, Takeishi, Yasuchika, Momose, Mitsuru, Takehana, Kazuya, Nanasato, Mamoru, Yoda, Syunichi, Nishina, Hidetaka, Matsumoto, Naoya, Nishimura, Tsunehiko
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; C-reactive protein; Cardiology; Cardiovascular morbidity; CONTRAST MEDIA; CORONARIES; DISEASE INCIDENCE; Disease-Free Survival; Electrocardiography; estimated glomerular filtration rate; Female; Glomerular Filtration Rate; HAZARDS; HEART FAILURE; Humans; Imaging; Japan; Kidney Failure, Chronic - diagnostic imaging; KIDNEYS; Male; Medicine; Medicine & Public Health; Middle Aged; Multivariate Analysis; MYOCARDIAL INFARCTION; Myocardial Perfusion Imaging; Nuclear Medicine; Original; Original Article; PATIENTS; Prognosis; Proportional Hazards Models; Prospective Studies; Radiology; RADIOLOGY AND NUCLEAR MEDICINE; REGRESSION ANALYSIS; Risk; SINGLE PHOTON EMISSION COMPUTED TOMOGRAPHY; Software; TECHNETIUM 99; Tomography, Emission-Computed, Single-Photon; Treatment Outcome
• ISSN: 1071-3581; 1532-6551; 1532-6551
• DOI: 10.1007/s12350-017-0880-5

Myocardial perfusion imaging (MPI) is considered useful for risk stratification among patients with chronic kidney disease (CKD), without renal deterioration by contrast media. The Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS 3) is a multicenter, prospective cohort study investigating the ability of MPI to predict cardiac events in 529 CKD patients without a definitive coronary artery disease. All patients were assessed by stress and rest MPI with 99mTc-tetrofosmin and data were analyzed using a defect scoring method and QGS software. Major cardiac events were analyzed for 3 years after registration. The mean eGFR was 29.0 ± 12.8 (mL/minute/1.73 m2). The mean summed stress/rest/difference (SSS, SRS, SDS) scores were 1.9 ± 3.8, 1.1 ± 3.0, and 0.8 ± 1.8, respectively. A total of 60 cardiac events (three cardiac deaths, six sudden deaths, five nonfatal myocardial infarctions, 46 hospitalization cases for heart failure) occurred. The event-free survival rate was lower among patients with kidney dysfunction, higher SSS, and higher CRP values. Multivariate Cox regression analysis independently associated SSS ≥8, eGFR