Perfusion SPECT and the impact of renal function on cardiac death 

Comment on the above paper

Chronic kidney disease (CKD) is an important risk factor for cardiovascular outcome.  In the present study, Hakeem et al studied a large cohort of patients (n=1652) with suspected CAD who underwent stress MPS and an evaluation of kidney function (by means of calculation of eGFR).  At baseline 36% had CKD defined as an eGFR < 60 ml/min/1.73m².  After a mean follow-up op 2 years both renal function and MPS showed incremental predictive power for cardiac death prediction over baseline risk factors and left ventricular dysfunction.  Importantly, patients with CKD had a relatively less benign prognosis that those without CKD, even in the presence of a normal scan.

1. Hakeem A, Bhatti S, Dillie K et al.   H, Engblom E, Naum A et al.  Predictive value of myocardial perfusion SPECT and the impact of renal function on cardiac death.  Circulation 2008;118:2540-2549.