Diagnostic accuracy and prognostic value of combined dipyridamole-exercise thallium imaging in hemodialysis patients
Autor: | Fabienne Pessione, Marc Faraggi, R. Gourgon, Michel Dahan, Amir Kolta, B. Legallicier, Dominique Le Guludec, Dominique L. Himbert, F Mignon, Beatrice Viron |
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Rok vydání: | 1998 |
Předmět: |
Male
Vasodilator Agents medicine.medical_treatment Coronary Disease Coronary Angiography Scintigraphy renal mortality Coronary artery disease chronic dialysis Myocardial infarction Thallium diabetes medicine.diagnostic_test Dipyridamole Middle Aged Prognosis myocardial infarction Nephrology cardiovascular system Female revascularization Radiology Hemodialysis medicine.symptom coronary artery disease medicine.drug Adult medicine.medical_specialty chemistry.chemical_element non-invasive imaging Asymptomatic Predictive Value of Tests Renal Dialysis medicine Humans cardiovascular diseases Tomography Emission-Computed Single-Photon business.industry Reproducibility of Results medicine.disease Survival Analysis chemistry Angiography Exercise Test Kidney Failure Chronic stress-thallium imaging business Follow-Up Studies |
Zdroj: | Kidney International. 54:255-262 |
ISSN: | 0085-2538 |
Popis: | Diagnostic accuracy and prognostic value of combined dipyridamole-exercise thallium imaging in hemodialysis patients.BackgroundNon-invasive detection of coronary artery disease in dialysis patients, a major cause of mortality, often remains difficult. The aim of the study was to test the diagnostic and prognostic accuracies of combined dipyridamole-exercise thallium imaging in dialysis patients.MethodsDipyridamole-exercise thallium imaging and coronary angiography were both performed prospectively in 60 asymptomatic hemodialysis patients who were followed up, long term, by recording any major coronary event.ResultsCoronary angiography was abnormal in 13 patients (21%), and there was abnormal thallium uptake in 17 patients. Sensitivity, specificity, positive and negative predictive values, and overall accuracy of thallium to detect a coronary artery disease were 92, 89, 71, 98 and 90%, respectively. After a median follow-up of 2.8years, 12 patients experienced at least one major coronary event (4 cardiac deaths, 5 myocardial infarctions and 3 revascularizations). Eight of the 17 patients with abnormal thallium uptake (47%) suffered a coronary event, compared to only 4 of the 43 patients (9%) with a normal thallium uptake (P < 0.001). The positive prognostic predictive value of thallium imaging was 47% and its negative predictive value was 91%. The probability of survival free of coronary events was significantly higher in patients with normal thallium uptake than in those with abnormal thallium uptake (crude risk ratio 7.6; P < 0.001) even after adjustment for several risk factors for cardiovacular disease (adjusted risk ratio 9.2; P < 0.005).ConclusionIn dialysis patients, combined dipyridamole-exercise thallium imaging is an acurate method for detecting coronary stenosis and for predicting future coronary events. |
Databáze: | OpenAIRE |
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