Page 47 - Cardiac testing for coronary artery disease in potential kidney transplant recipients
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De Lima 2003 (Continued)
• Sex: 77% male
Study design Cohort study.
Target condition and reference standard(s) Coronary artery stenosis measured by coronary angiography
• The criterion for positive test results was ≥ 70% reduction in cross sectional area.
Invasive and non-invasive testing were analysed independently by 2 experts in the
respective methods without previous knowledge of the experimental hypothesis.
Disagreement was arbitrated by a third expert.
Index and comparator tests DSE
• Stepwise infusion of dobutamine was started at 5 µg/kg/min and increased to 40
µg/kg/min in 3 minute stages. Inducible ischaemia was defined as hypokinesis or as
accentuation of the degree of baseline hypokinesis during the infusion. The test was
interrupted if SBP or DBP surpassed 220 mm Hg and 120 mm Hg, respectively, or
when SBP fell below 90 mm Hg.
• Dipyridamole stress testing (single photon emission-computed tomography with
technecium-99m methoxyisobutylisonitrite)
◦ Stress was induced by dipyridamole (0.5 mg/kg IV). Fixed perfusion defects
were interpreted as evidence of fibrosis; transient hypoperfusion was interpreted as
ischaemia.
Follow-up Five participants were lost to follow-up. Minimum and mean follow-up periods were
6 and 26 months, respectively. The outcome measure was cardiac events, predefined
as sudden death, MI, life-threatening arrhythmia, heart failure, pulmonary oedema,
unstable angina, and myocardial revascularisation
Notes
Table of Methodological Quality
Item Authors’ judgement Description
Representative spectrum? Yes Kidney transplantation candidates as part
All tests of cardiac evaluation
Acceptable reference standard? Yes Coronary angiography with a reference
All tests standard threshold of ≥ 70% stenosis
Acceptable delay between tests? Yes Interval between tests was 2 to 6 weeks (au-
All tests thor correspondence)
Partial verification avoided? Yes All participants who underwent an index
All tests test also received the reference standard test
Differential verification avoided? Yes Disease status (CAD) diagnosed by coro-
All tests nary angiography.
Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 45
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.