open access

Vol 17, No 4 (2010)
Original articles
Published online: 2010-07-27
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Coronary computed tomography angiography in dialysis patients undergoing pre-renal transplantation cardiac risk stratification

Justin Mao, Vanji Karthikeyan, Chad Poopat, Thomas Song, Milan Pantelic, Joseph Chattahi, João L. Cavalcante, Karthik Ananthasubramaniam
Cardiol J 2010;17(4):349-361.

open access

Vol 17, No 4 (2010)
Original articles
Published online: 2010-07-27

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).
(Cardiol J 2010; 17, 4: 349-361)

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).
(Cardiol J 2010; 17, 4: 349-361)
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Keywords

coronary computed tomography angiography; end stage renal disease; coronary artery disease; renal transplantation; risk stratification; dobutamine echocardiography; stress myocardial perfusion imaging

About this article
Title

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

Journal

Cardiology Journal

Issue

Vol 17, No 4 (2010)

Pages

349-361

Published online

2010-07-27

Bibliographic record

Cardiol J 2010;17(4):349-361.

Keywords

coronary computed tomography angiography
end stage renal disease
coronary artery disease
renal transplantation
risk stratification
dobutamine echocardiography
stress myocardial perfusion imaging

Authors

Justin Mao
Vanji Karthikeyan
Chad Poopat
Thomas Song
Milan Pantelic
Joseph Chattahi
João L. Cavalcante
Karthik Ananthasubramaniam

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