The online version of this article (https://doi.org/10.1007/s12350-018-1330-8) contains supplementary material, which is available to authorized users.
The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarizes the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.
This study was supported by grants from the Japan Cardiovascular Research Foundation.
This study aimed to validate the accuracy of major-event risk models created in the multicenter J-ACCESS prognostic study in a new cohort of patients with chronic kidney disease (CKD).
Three multivariable J-ACCESS risk models were created to predict major cardiac events (cardiac death, non-fatal acute coronary syndrome, and severe heart failure requiring hospitalization): Model 1, four variables of age, summed stress score, left ventricular ejection fraction and diabetes; Model 2 with five variables including estimated glomerular filtration rate (eGFR, continuous); and Model 3 with categorical eGFR. The validation data used three-year (3y) cohort of patients with CKD (n = 526, major events 11.2%). Survival analysis of low (< 3%/3y), intermediate (3% to 9%/3y), and high (> 9%/3y)-risk groups showed good stratification by all three models (actual event rates: 3.1%, 9.9%, and 15.9% in the three groups with eGFR ≥ 15 mL/min/1.73 m2, P = .0087 (Model 2). However, actual event rates were equally high across all risk groups of patients with eGFR < 15 mL/min/1.73 m2.
The J-ACCESS risk models can stratify patients with CKD and eGFR ≥ 15 mL/min/1.73 m2, but patients with eGFR < 15 mL/min/1.73 m2 are potentially at high risk regardless of estimated risk values.
Supplementary material 1 (PPTX 839 kb)12350_2018_1330_MOESM1_ESM.pptx
Hachamovitch R, Hayes SW, Friedman JD, Cohen I, Berman DS. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation. 2003;107:2900–7. CrossRefPubMed
Shaw LJ, Berman DS, Hendel RC, Alazraki N, Krawczynska E, Borges-Neto S, et al. Cardiovascular disease risk stratification with stress single-photon emission computed tomography technetium-99m tetrofosmin imaging in patients with the metabolic syndrome and diabetes mellitus. Am J Cardiol. 2006;97:1538–44. CrossRefPubMed
Shaw LJ, Berman DS, Maron DJ, Mancini GB, Hayes SW, Hartigan PM, et al. Optimal medical therapy with or without percutaneous coronary intervention to reduce ischemic burden: Results from the clinical outcomes utilizing revascularization and aggressive drug evaluation (COURAGE) trial nuclear substudy. Circulation. 2008;117:1283–91. CrossRefPubMed
Nakamura S, Kawano Y, Nakajima K, Hase H, Joki N, Hatta T, et al. Prognostic study of cardiac events in Japanese patients with chronic kidney disease using ECG-gated myocardial Perfusion imaging: Final 3-year report of the J-ACCESS 3 study. J Nucl Cardiol. 2017. https://doi.org/10.1007/s12350-017-0880-5. CrossRefPubMed
Aburadani I, Usuda K, Sumiya H, Sakagami S, Kiyokawa H, Matsuo S, et al. Ability of the prognostic model of J-ACCESS study to predict cardiac events in a clinical setting: The APPROACH study. J Cardiol. 2018. https://doi.org/10.1016/j.jjcc.2017.12.006. PubMedCrossRef
- Risk stratification based on J-ACCESS risk models with myocardial perfusion imaging: Risk versus outcomes of patients with chronic kidney disease
MD, PhD Kenichi Nakajima
MD, PhD Satoko Nakamura
MD, PhD Hiroki Hase
MD, PhD Yasuchika Takeishi
MD, PhD Shigeyuki Nishimura
MD, PhD Yuhei Kawano
MD, PhD Tsunehiko Nishimura
- Springer US
Journal of Nuclear Cardiology
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
Neu im Fachgebiet Kardiologie
Mail Icon II