Prognostic value of myocardial perfusion imaging in patients with chronic kidney disease: A systematic review and meta-analysis.
CAD
Diagnostic and prognostic application
MPI
Meta-analysis
SPECT
Journal
Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
ISSN: 1532-6551
Titre abrégé: J Nucl Cardiol
Pays: United States
ID NLM: 9423534
Informations de publication
Date de publication:
Feb 2022
Feb 2022
Historique:
received:
14
10
2020
accepted:
14
11
2020
pubmed:
4
1
2021
medline:
30
4
2022
entrez:
3
1
2021
Statut:
ppublish
Résumé
We performed a systematic review and meta-analysis to investigate the prognostic value of stress myocardial perfusion single-photon emission computed tomography (MPS) in predicting adverse cardiovascular events in patients with chronic kidney disease (CKD). Studies published from inception until July 2020 were identified by PubMed and Embase databases search. Studies were included if they evaluated CKD patients referred for stress MPS, providing data on adjusted hazard ratio (HR) for the occurrence of adverse events. For studies providing only non-adjusted HR, the univariable risk estimate was included in the analysis. Pooled HR and 95% confidence interval (CI) were estimated using a random effects model to compare patients with abnormal and normal MPS. Whenever possible, incidence rate ratio (IRR) was also calculated and pooled. Sixteen eligible studies were identified including 7834 patients with a follow-up range from 1 to 4.4 years. Eleven articles included patients with end-stage renal disease (IV-V CKD stage), 3 articles with III-V CKD stage and 2 articles with I-V CKD stage. The pooled HR for the occurrence of adverse events was 2.02 (95% CI 1.68-2.42) and heterogeneity was 34%. Among the included studies, 5 reported the HR for the occurrence of hard events, with a pooled HR of 2.36 (95% CI 1.77-3.13). A total of 8 studies reported data useful to calculate the IRR in patients with normal and abnormal perfusion. The pooled IRR was 2.37 (95% CI 1.63-3.47) and heterogeneity was 60%. At meta-regression analysis, we found an association between HR for adverse events and age, hypertension and smoking, while no significant association was found between HR for hard events and demographic and clinical variables. In patients with CKD an abnormal myocardial perfusion at stress MPS is associated with adverse cardiovascular events.
Sections du résumé
BACKGROUND
BACKGROUND
We performed a systematic review and meta-analysis to investigate the prognostic value of stress myocardial perfusion single-photon emission computed tomography (MPS) in predicting adverse cardiovascular events in patients with chronic kidney disease (CKD).
METHODS
METHODS
Studies published from inception until July 2020 were identified by PubMed and Embase databases search. Studies were included if they evaluated CKD patients referred for stress MPS, providing data on adjusted hazard ratio (HR) for the occurrence of adverse events. For studies providing only non-adjusted HR, the univariable risk estimate was included in the analysis. Pooled HR and 95% confidence interval (CI) were estimated using a random effects model to compare patients with abnormal and normal MPS. Whenever possible, incidence rate ratio (IRR) was also calculated and pooled.
RESULTS
RESULTS
Sixteen eligible studies were identified including 7834 patients with a follow-up range from 1 to 4.4 years. Eleven articles included patients with end-stage renal disease (IV-V CKD stage), 3 articles with III-V CKD stage and 2 articles with I-V CKD stage. The pooled HR for the occurrence of adverse events was 2.02 (95% CI 1.68-2.42) and heterogeneity was 34%. Among the included studies, 5 reported the HR for the occurrence of hard events, with a pooled HR of 2.36 (95% CI 1.77-3.13). A total of 8 studies reported data useful to calculate the IRR in patients with normal and abnormal perfusion. The pooled IRR was 2.37 (95% CI 1.63-3.47) and heterogeneity was 60%. At meta-regression analysis, we found an association between HR for adverse events and age, hypertension and smoking, while no significant association was found between HR for hard events and demographic and clinical variables.
CONCLUSIONS
CONCLUSIONS
In patients with CKD an abnormal myocardial perfusion at stress MPS is associated with adverse cardiovascular events.
Identifiants
pubmed: 33389636
doi: 10.1007/s12350-020-02449-x
pii: 10.1007/s12350-020-02449-x
doi:
Types de publication
Journal Article
Meta-Analysis
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
141-154Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2021. American Society of Nuclear Cardiology.
Références
Sarnak MJ, Amann K, Bangalore S, Cavalcante JL, Charytan DM, Craig JC, et al. Chronic kidney disease and coronary artery disease: JACC state-of-the-art review. J Am Coll Cardiol 2019;74:1823-38.
pubmed: 31582143
Shroff GR, Chang TI. Risk stratification and treatment of coronary disease in chronic kidney disease and end-stage kidney disease. Rev Semin Nephrol 2018;38:582-99.
Levi A, Simard T, Glover C. Coronary artery disease in patients with end-stage kidney disease; current perspective and gaps of knowledge. Semin Dial 2020;33:187-97.
pubmed: 32449824
Winther S, Svensson M, Jørgensen HS, Rasmussen LD, Holm NR, Gormsen LC, et al. Prognostic value of risk factors, calcium score, coronary CTA, myocardial perfusion imaging, and invasive coronary angiography in kidney transplantation candidates. JACC Cardiovasc Imaging 2018;11:842-54.
pubmed: 28917674
Al-Mallah MH, Hachamovitch R, Dorbala S, Di Carli MF. Incremental prognostic value of myocardial perfusion imaging in patients referred to stress single-photon emission computed tomography with renal dysfunction. Circ Cardiovasc Imaging 2009;2:429-36.
pubmed: 19920040
Rabbat CG, Treleaven DJ, Russell JD, Ludwin D, Cook DJ. Prognostic value of myocardial perfusion studies in patients with end-stage renal disease assessed for kidney or kidney-pancreas transplantation: A meta-analysis. J Am Soc Nephrol 2003;14:431-9.
pubmed: 12538744
Chew CG, Unger S, Shakib S. Value of myocardial perfusion imaging in renal transplant evaluation. Nephrology 2013;18:376-81.
pubmed: 23490219
Hage FG, Smalheiser S, Zoghbi GJ, Perry GJ, Deierhoi M, Warnock D, et al. Predictors of survival in patients with end-stage renal disease evaluated for kidney transplantation. Am J Cardiol 2007;100:1020-5.
pubmed: 17826390
Wang LW, Masson P, Turner RM, Lord SW, Baines LA, Craig JC, et al. Prognostic value of cardiac tests in potential kidney transplant recipients: A systematic review. Transplantation 2015;99:731-45.
pubmed: 25769066
Helve S, Nieminen T, Helanterä I, Finne P, Rajala H, Sinisalo J, et al. The value of myocardial perfusion imaging in screening coronary artery disease before kidney transplantation. Clin Transplant 2020;34(8):e13894.
pubmed: 32365261
Spruance SL, Reid JE, Grace M, Samore M. Hazard ratio in clinical trials. Antimicrob Agents Chemother 2004;48:2787-92.
pubmed: 15273082
pmcid: 478551
Moher D, Liberati A, Tetzlaff J, Altman DG, PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med 2009;6:e1000097.
pubmed: 19621072
pmcid: 2707599
Hayden JA, Côté P, Bombardier C. Evaluation of the quality of prognosis studies in systematic reviews. Ann Intern Med 2006;144:427-37.
pubmed: 16549855
Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 2007;8:16.
pubmed: 17555582
pmcid: 1920534
DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials 1986;7:177-88.
pubmed: 3802833
Cleophas TJ, Zwinderman AH. Meta-analysis. Circulation 2007;115:2870-5.
pubmed: 17548743
Higgins JP, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med 2002;21:1539-58.
pubmed: 12111919
Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by a simple, graphical test. BMJ 1997;315:629-34.
pubmed: 9310563
pmcid: 2127453
Duval S, Tweedie R. A nonparametric “trim and fill” method of accounting for publication bias in meta-analysis. J Am Stat Assoc 2000;95:89-98.
Duval S, Tweedie R. Trim and fill: a simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics 2000;56:455-63.
pubmed: 10877304
Wallace BC, Schmid CH, Lau J, Trikalinos TA. Meta-Analyst: software for meta-analysis of binary, continuous and diagnostic data. BMC Med Res Methodol 2009;9:80.
pubmed: 19961608
pmcid: 2795760
Hakeem A, Bhatti S, Dillie KS, Cook JR, Samad Z, Roth-Cline MD, et al. Predictive value of myocardial perfusion single-photon emission computed tomography and the impact of renal function on cardiac death. Circulation 2008;118:2540-9.
pubmed: 19047585
Chan MY, Wong HB, Ong HY, Yeo TC. Prognostic value of left atrial size in chronic kidney disease. Eur J Echocardiogr 2008;9:736-40.
pubmed: 18490301
Venkataraman R, Hage FG, Dorfman T, Heo J, Aqel RA, de Mattos AM, et al. Role of myocardial perfusion imaging in patients with end-stage renal disease undergoing coronary angiography. Am J Cardiol 2008;102:1451-6.
pubmed: 19026294
De Vriese AS, De Bacquer DA, Verbeke FH, De Winter O, Franken PR, De Sutter JH, et al. Comparison of the prognostic value of dipyridamole and dobutamine myocardial perfusion scintigraphy in hemodialysis patients. Kidney Int 2009;76:428-36.
pubmed: 19494798
Hatta T, Nishimura S, Nishimura T. Prognostic risk stratification of myocardial ischaemia evaluated by gated myocardial perfusion SPECT in patients with chronic kidney disease. Eur J Nucl Med Mol Imaging 2009;36:1835-41.
pubmed: 19471925
Furuhashi T, Moroi M, Joki N, Hase H, Masai H, Kunimasa T, et al. Impact of chronic kidney disease and stress myocardial perfusion imaging as a predictor of cardiovascular events. Ann Nucl Med 2011;25:616-24.
pubmed: 21720779
Kim JK, Kim SG, Kim HJ, Song YR. Cardiac risk assessment by gated single-photon emission computed tomography in asymptomatic end-stage renal disease patients at the start of dialysis. J Nucl Cardiol 2012;19:438-47.
pubmed: 22203446
Joki N, Hase H, Kawano Y, Nakamura S, Nakajima K, Hatta T, et al. Myocardial perfusion imaging for predicting cardiac events in Japanese patients with advanced chronic kidney disease: 1-year interim report of the J-ACCESS 3 investigation. Eur J Nucl Med Mol Imaging 2014;4:1701-9.
Moody WE, Lin EL, Stoodley M, McNulty D, Thomson LE, Berman DS, et al. Prognostic utility of calcium scoring as an adjunct to stress myocardial perfusion scintigraphy in end-stage renal disease. Am J Cardiol 2016;117:1387-96.
pubmed: 26996769
pmcid: 4837228
Callan PD, Bhandari S, Clark AL, Eadington D, Papadopoulos E, Tweddel AC. The utility of myocardial perfusion imaging before renal transplantation: A retrospective analysis. Nucl Med Commun 2018;39:228-35.
pubmed: 29298216
Helve S, Laine M, Sinisalo J, Helanterä I, Hänninen H, Lammintausta O, et al. Even mild reversible myocardial perfusion defects predict mortality in patients evaluated for kidney transplantation. Eur Heart J Cardiovasc Imaging 2018;19:1019-25.
pubmed: 28977433
Park GH, Song JW, Lee CM, Song YR, Kim SG, Kim HJ, et al. Long-term prognosis of end-stage renal disease patients with normal myocardial perfusion as determined by single photon emission computed tomography. Korean J Intern Med 2018;33:148-56.
pubmed: 27871168
Kolkailah AA, Iskander M, Iskander F, Patel PP, Khan R, Doukky R. The prognostic utility of regadenoson SPECT myocardial perfusion imaging in patients with end-stage renal disease: The largest cohort to date. J Nucl Cardiol 2020. https://doi.org/10.1007/s12350-020-02259-1 .
pubmed: 32632913
Golzar Y, Doukky R. Stress SPECT myocardial perfusion imaging in end-stage renal disease. Curr Cardiovasc Imaging Rep 2017;10:13.
pubmed: 28685008
pmcid: 5495196
Kahn MR, Fallahi A, Kim MC, Esquitin R, Robbins MJ. Coronary artery disease in a large renal transplant population: Implications for management. Am J Transplant 2011;11:2665-74.
pubmed: 21920018
De Lima JJ, Wolff Gowdak LH, de Paula FJ, Ianhez LE, Franchini Ramires JA, Krieger EM. Validation of a strategy to diagnose coronary artery disease and predict cardiac events in high-risk renal transplant candidates. Coron Artery Dis 2010;21:164-7.
pubmed: 20299981
Sterne JA, Sutton AJ, Ioannidis JP, Terrin N, Jones DR, Lau J, et al. Recommendations for examining and interpreting funnel plot asymmetry in meta-analyses of randomized controlled trials. BMJ 2011;343:4002.