Page 41 - Cardiac testing for coronary artery disease in potential kidney transplant recipients

Bennett 1978 (Continued)

Withdrawals explained? Yes All patients missing from the final analysis
All tests were accounted for

Boudreau 1990

Clinical features and settings Clinical features
• Patients with DM type 1 and ESKD who presented for kidney transplant
evaluation
Setting
• University of Minnesota Hospital and Clinics, Minnesota, USA

Participants • Number: 80
• DM type 1: 100%
• Angina pectoris: 12.5% patients had history of myocardial infarction
• Hypertension: Not reported
• Sex: 64% male

Study design Cross sectional study.

Target condition and reference standard(s) Coronary artery stenosis measured by coronary angiography
• Coronary angiograms were analysed by a blinded observer who was unaware of
thallium scan results or the patient’s history. Quantitative analysis sought to determine
the percentage of cross sectional narrowing and absolute cross sectional diameter. The
criterion for positive test results was ≥ 70% reduction in cross sectional area.

Index and comparator tests Dipyridamole-Tl-201 scintigraphy MPS (40 oral, 40 IV dipyridamole)
• Scans interpreted by consensus of three experienced radiologists who were
unaware of angiography results or patient history. Each view was subdivided into five
segments, and the stress views (first set of images) examined for areas of reduced
activity. Categorisation as ’indeterminate’ was not permitted. Stress segments classified
as abnormal were examined for definite, possible, or absent redistribution. Other
categories were ’positive’ and ’fixed defect’. Mixed defects were defined as areas of
partial redistribution in a fixed defect or fixed defects in association with reversible
defects. Quantitative analysis, including count profiles and washout rates, was also
performed. However, only qualitative results were used to reach the final diagnosis,
since normal quantitative values are unavailable for this test in this patient population.

Follow-up None.

Notes Patients were reported as being followed-up long-term to assess the risk factors (including
the thallium scan) for cardiac events after kidney transplantation, although no published
data were available

Table of Methodological Quality

Item Authors’ judgement Description

Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 39
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.