The prognostic value of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease

Abstract

Regadenoson-stress SPECT-MPI provides a significant prognostic value in patients with ESRD. ESRD patients with normal SPECT-MPI have relatively high adverse event rates.

Safety of stress testing in patients with elevated cardiac biomarkers: Are all modalities created equal?

“…A growing body of literature establishing the prognostic value of regadenoson radionuclide MPI as an equivalent to adenosine stress soon followed. [8][9][10][11] However, to date, there has not been a large study affirming the safety of regadenoson in post-MI patients or those with elevated cardiac troponin levels. The question can be asked: since they are similar in clinical utility, why cannot we extrapolate the safety profile of adenosine to regadenoson?…”

Cardiovascular risk assessment with regadenoson SPECT MPI in patients with end-stage renal disease is safe, effective, and well tolerated: Does it matter?

“…10 The investigators analyzed 303 patients who were followed for approximately 3 years. Adjusting for clinical covariates, abnormal regadenoson-stress MPI (SSS C4) was associated with increased risk of the composite of cardiac death or MI (23.9% vs 14.4%; HR 1.88; CI 1.04-3.41; P = .037) and the composite of cardiac death, MI, or late cardiac revascularization (27.3% vs 16.7%; HR 1.80; CI 1.03-3.14; P = .039).…”

Ischemia and inflammation on chronic kidney disease

“…A number of reports indicated prognostic value of MPI suggested for patients with suspected or extant CAD and those with CKD. [8][9][10][11][12][13][14][15] The current report is a multicenter prospective cohort study in Japan to determine the ability of MPI to diagnose CAD and predict the outcomes of patients with CKD who are not definitively diagnosed with CAD (This study). The study aimed to clarify whether MPI can predict cardiac events and determine whether renal dysfunction combined with MPI abnormalities provides additional prognostic information to conventional markers.…”

“…This finding seems to be concordant to the previous findings indicating importance of myocardial ischemia for CKD patient outcome. [10][11][12][13][14][15] In other words, CKD patients with severe myocardial ischemia with reduced eGFR with or without elevated CRP are suitable candidates for coronary angiography and subsequent coronary intervention in order to improve their outcome.…”

“…This is somewhat different from many previous prognostic reports using gated perfusion SPECT. [8][9][10][11][12][13][14][15] In addition, the patient criteria include those with suspected ischemic CAD. It seems to be important to clarify how many of them have symptomatic and unstable conditions, indicating angina at rest or unstable angina.…”