Validation of a strategy to diagnose coronary artery disease and predict cardiac events in high-risk renal transplant candidates
Coronary Artery Disease, ISSN: 0954-6928, Vol: 21, Issue: 3, Page: 164-167
2010
- 15Citations
- 69Captures
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Example: if you select the 1-year option for an article published in 2019 and a metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019. If you select the 3-year option for the same article published in 2019 and the metric category shows 90%, that means that the article or review is performing better than 90% of the other articles/reviews published in that journal in 2019, 2018 and 2017.
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Metrics Details
- Citations15
- Citation Indexes15
- 15
- CrossRef14
- Captures69
- Readers69
- 69
Article Description
Background: We validated a strategy for diagnosis of coronary artery disease (CAD) and prediction of cardiac events in high-risk renal transplant candidates (at least one of the following: age ≥ 50 years, diabetes, cardiovascular disease). Methods: A diagnosis and risk assessment strategy was used in 228 renal transplant candidates to validate an algorithm. Patients underwent dipyridamole myocardial stress testing and coronary angiography and were followed up until death, renal transplantation, or cardiac events. Results: The prevalence of CAD was 47%. Stress testing did not detect significant CAD in 1/3 of patients. The sensitivity, specificity, and positive and negative predictive values of the stress test for detecting CAD were 70, 74, 69, and 71%, respectively. CAD, defined by angiography, was associated with increased probability of cardiac events [log-rank: 0.001; hazard ratio: 1.90, 95% confidence interval (CI): 1.29-2.92]. Diabetes (P=0.03; hazard ratio: 1.58, 95% CI: 1.06-2.45) and angiographically defined CAD (P=0.03; hazard ratio: 1.69, 95% CI: 1.08-2.78) were the independent predictors of events. Conclusion: The results validate our observations in a smaller number of high-risk transplant candidates and indicate that stress testing is not appropriate for the diagnosis of CAD or prediction of cardiac events in this group of patients. Coronary angiography was correlated with events but, because less than 50% of patients had significant disease, it seems premature to recommend the test to all high-risk renal transplant candidates. The results suggest that angiography is necessary in many high-risk renal transplant candidates and that better noninvasive methods are still lacking to identify with precision patients who will benefit from invasive procedures. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=77951296050&origin=inward; http://dx.doi.org/10.1097/mca.0b013e328332ee5e; http://www.ncbi.nlm.nih.gov/pubmed/20299981; http://content.wkhealth.com/linkback/openurl?sid=WKPTLP:landingpage&an=00019501-201005000-00006; https://journals.lww.com/00019501-201005000-00006; https://dx.doi.org/10.1097/mca.0b013e328332ee5e; https://journals.lww.com/coronary-artery/Abstract/2010/05000/Validation_of_a_strategy_to_diagnose_coronary.6.aspx
Ovid Technologies (Wolters Kluwer Health)
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