Back to Search Start Over

Stress echocardiography for risk stratification in patients with end-stage renal disease undergoing renal transplantation.

Authors :
Tita C
Karthikeyan V
Stroe A
Jacobsen G
Ananthasubramaniam K
Source :
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography [J Am Soc Echocardiogr] 2008 Apr; Vol. 21 (4), pp. 321-6. Date of Electronic Publication: 2007 Jul 27.
Publication Year :
2008

Abstract

Background: The predictive accuracy of stress echocardiography (SE) for adverse cardiac events has been variable in the population with end-stage renal disease undergoing renal transplantation (RT).<br />Methods: We performed a retrospective study of 149 patients who had pretransplant SE before RT between 1997 and 2003. Patients were followed up for a mean of 2.85 years for major adverse cardiovascular events (MACE).<br />Results: Of 149 patients studied, 139 had a negative SE, 65% were African American; 12 underwent cardiac catheterization. Only 1 patient required pre-RT revascularization. Sixteen MACE occurred over the follow-up period. SE had 37.5% sensitivity, 95.3% specificity, 33.3% positive predictive value, and 96.1% negative predictive value for MACE in the first year post-RT. First-year posttransplant event rates were 4.0% versus 30% (P < .001) for patients with a negative SE and positive SE, respectively. Multivariate predictors of MACE were positive SE (hazard ratio [HR] 7.64), hemoglobin less than 11 g/dL post-RT (HR 4.44), and calcium channel blocker use posttransplant (HR 2.90).<br />Conclusions: A negative SE has low incidence of MACE in this intermediate- to high-risk patient subset. A positive SE predicts a sevenfold higher risk of cardiovascular events regardless of the need for revascularization before the transplant.

Details

Language :
English
ISSN :
1097-6795
Volume :
21
Issue :
4
Database :
MEDLINE
Journal :
Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography
Publication Type :
Academic Journal
Accession number :
17681725
Full Text :
https://doi.org/10.1016/j.echo.2007.06.004