Coronary computed tomography angiography in dialysis patients undergoing pre-renal transplantation cardiac risk stratification.

Abstract:

BACKGROUND:This study addresses the safety, feasibility, and interpretability of coronary computed tomography angiography (CCTA) in excluding significant coronary artery disease in end-stage renal disease patients on dialysis undergoing pre-renal transplant cardiac risk evaluation. METHODS:Twenty nine patients (55.5 +/- 10.2 years) undergoing cardiac risk assessment prior to renal transplantation, underwent research CCTA with calcium scoring and formed the study group. All CCTAs were performed using retrospective acquisition, with beta-blockade provided one hour prior to scanning. RESULTS:No major complications occurred in this group up to 30 days after CCTA. Of the total of 374 segments interpreted by both readers, only 36 (10%) were uninterpretable by both readers. Of these, 31 (86%) were from distal segments or branches. On a segmental level, there was 95% concordance between both readers for < 50% stenosis detection. Only three out of 28 (11%) CCTAs were deemed uninterpretable. Ten patients (36%) had zero calcium score, despite being on dialysis with no evidence of obstructive coronary artery disease by CCTA. CONCLUSIONS:CCTA is feasible and safe in end-stage renal disease dialysis patients with the advent of 64-slice CCTA. Despite significant calcium burden, there was excellent inter-observer agreement at segment level for the left main and all three proximal-mid coronary arteries in excluding obstructive coronary artery disease (> 50% stenosis).

journal_name

Cardiol J

journal_title

Cardiology journal

authors

Mao J,Karthikeyan V,Poopat C,Song T,Pantelic M,Chattahi J,Cavalcante JL,Ananthasubramaniam K

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

349-61

issue

4

issn

1897-5593

journal_volume

17

pub_type

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