Silent myocardial infarction on preoperative electrocardiogram for kidney transplant patients: Impact on clinical outcomes may not be silent

Emerging Evidence on Coronary Heart Disease Screening in Kidney and Liver Transplantation Candidates: A Scientific Statement From the American Heart Association

“…36 The revised approach proposes eliminating several of the original 8 ACC/AHA risk factors, some of which (eg, hypertension) are so ubiquitous among kidney transplantation candidates as to be unhelpful for risk stratification, and introduces new risk factors, including silent MI on ECG, which has been shown to have prognostic significance in kidney transplantation candidates and recipients. 37,38 Although the type, duration, and control of comorbidities, including diabetes, are doubtless important in clinical practice, we are unable to go into a greater level of granularity in this high-level document, especially because the existing literature frequently does not provide that level of detail. The approach also incorporates new modalities such as coronary computed tomography angiography (CCTA), although we chose stress echocardiography (SE) as the modality of choice‚ given its good sensitivity/specificity, lack of radiation exposure, and ability to provide dynamic structural information such as extent of contractile reserve in the presence of valvular disease, which is common in CKD.…”