Risk stratification based on J-ACCESS risk models with myocardial perfusion imaging: Risk versus outcomes of patients with chronic kidney disease

Abstract

The J-ACCESS risk models can stratify patients with CKD and eGFR ≥ 15 mL/min/1.73 m, but patients with eGFR < 15 mL/min/1.73 m are potentially at high risk regardless of estimated risk values.

Cardiovascular risk prediction models with myocardial perfusion imaging in chronic kidney disease: ACCESSing digits or focusing on the patient?

“…14 Follow-up studies, such as the J-ACCESS-3 demonstrated the ability and usefulness of SPECT-MPI to predict 3-year outcomes in patients with chronic kidney disease (CKD), a condition well associated with the risk of death, hospitalization as well as cardiovascular events. 15 To complement these previous findings, in the current issue of the Journal, Nakajima et al 16 investigated the accuracy of three risk models derived from the J-ACCESS study to predict major events in a new cohort of 526 patients with CKD. One four-and two fiveparametric models were utilized, with the latter two including information on the stage of CKD (as absolute estimated glomerular filtration rate (eGFR) numbers and as categorical values, respectively).…”

“…al. 16 represents a further step towards a more accurate prediction of cardiovascular events by combining SPECT-MPI findings and clinical risk factors for the Japanese population.…”

Cardiovascular event risk estimated after coronary revascularization and optimal medical therapy: J-ACCESS4 prognostic study

“…Several risk factors that J-ACCESS associated with cardiac events [11] were included in risk estimation. The Heart Risk View-S software (HRV-S) calculated the probability of major cardiac events, including cardiac death, non-fatal myocardial infarction, and hospitalization due to severe heart failure, occurring over a period of 3 years, using the following equation based on a multi-variable logistic model [12][13][14][15]:…”

“…Three-year cardiac event risk can be estimated based on the J-ACCESS risk model, which has been incorporated into Heart Risk View (HRV) software. This software calculates the probability (%) of major cardiac events (cardiac death, nonfatal myocardial infarction, and severe heart failure requiring hospitalization) arising during 3 years of follow-up [12][13][14][15]. The J-ACCESS4 study then clarified the prognostic impact of reducing myocardial ischemia among Japanese patients with stable CAD [6,16].…”

Status of Nuclear Cardiology Progress in Japan 2020

“…Cardiac events, including cardiac death, sudden death, non-fatal myocardial infarction and hospitalization due to heart failure, developed in 60 (11%) of 529 patients 32) , and 46 (77 %) were admitted to hospitals with heart failure. The J-ACCESS risk model to predict major cardiac events showed that patients with estimated glomerular filtration rates (eGFR) of < 15 L/min/1.73 m 2 were at significantly higher risk regardless of other risk values 33) . Both 123 I-BMIPP and J-ACCESS 3 studies found higher risk profiles in patients with chronic kidney disease, typically those on hemodialysis.…”