Prognostic risk stratification of myocardial ischaemia evaluated by gated myocardial perfusion SPECT in patients with chronic kidney disease.

Abstract

The aim of this study was to identify useful predictors of cardiac events in patients with chronic kidney disease (CKD). Among 4,031 patients identified from the Japanese Assessment of Cardiac Events and Survival Study (J-ACCESS) database with suspected or known ischaemic heart disease, we selected 820 with an estimated glomerular filtration rate (eGFR) of < 60 ml/min per 1.73 m(2). A total of 75 cardiac events developed among these 820 patients. The incidence of cardiac events was higher in the group with a lower eGFR. Multivariate Cox analysis indicated that age, diabetes mellitus, end-systolic volume, summed stress score (SSS) and eGFR were predictors of cardiac events. Event rates of patients with SSS >or= 9 were significantly higher in groups with lower eGFR values (< 40 and 40-49 ml/min). The SSS value (>or= 9) is a reliable predictor of cardiac events and myocardial single photon emission computed tomography has incremental value for predicting cardiac events and survival in CKD.