Predicting cardiac events with Tl201 dipyridamole myocardial scintigraphy in renal transplant recipients

J Nephrol. Jan-Feb 2002;15(1):48-53.

Abstract

Background: Renal transplant recipients should be screened for coronary artery disease. The purpose of this study was to evaluate the usefulness of thallium-201 dipyridamole myocardial perfusion single-photon emission computed tomography (SPECT) to predict major cardiac events in these patients.

Methods and results: Eighty-two consecutive patients (61 males) in hemodialysis (HD) treatment, awaiting renal transplantation, underwent dipyridamole Tl-201 SPECT for pretransplant risk stratification. SPECT semiquantitative analysis showed a normal perfusion pattern in 52 patients (group A) and fixed defects in 9 (group B). Reversible perfusion defects were found in 21 (group C). Cardiac death, myocadial infarction, and unstable angina were sought as cardiac events. During a follow-up lasting 28.3 +/- 21.6 months, three patients of group A died for a non-cardiac cause. In group C, six patients (28.6%) had a cadiac event: one had a non-q wave myocardial infarction after renal transplantation; five were admitted with unstable angina. No cardiac events were observed in groups A and B (p = 0.0001). SPECT semiquantitative analysis showed that a summed difference score > or = 3 significantly increased the risk of cardiac events (odds ratio 4.5, C.I. 2.5-8.1).

Conclusion: Cardiac events were only observed in HD patients with Tl-201 SPECT dipyridamole reversible defects (group C). A normal pattern or a fixed defect in Tl-201 dipyridamole SPECT in HD patients identified a good long-term prognosis.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Coronary Artery Disease / diagnostic imaging*
  • Female
  • Humans
  • Kidney Transplantation*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Renal Dialysis
  • Risk Factors
  • Sensitivity and Specificity
  • Thallium Radioisotopes*
  • Tomography, Emission-Computed, Single-Photon*

Substances

  • Thallium Radioisotopes