Page 54 - Cardiac testing for coronary artery disease in potential kidney transplant recipients

Garg 2000

Clinical features and settings Clinical features
• Patients with DM who were candidates for kidney transplant
Setting
• Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow, India

Participants • Number: 52
• DM: 100%
• Angina pectoris: not reported
• Hypertension: 100%
• Sex: 88% male
• Age (Mean ± SD): 46 ± 6 years

Study design Cohort study.

Target condition and reference standard(s) Coronary artery stenosis measured by coronary angiography
• Criterion for positive test results was ≥ 50 reduction in cross sectional area. Each
angiogram was independently reviewed by two experienced cardiologists who were
blinded to the clinical data and uninvolved in patient management.
Index and comparator tests DSTS
• Patients received400 mg oral dipyridamole and 1.5 mCi Tl-201 injected IV one
hour after DSTS. Studies were interpreted qualitatively and quantitatively. Planar
thallium was performed in all cases. Normal test results were characterised by: the
patient had no chest pain, no significant ST depression in the ECG during stress, and
no significant perfusion defect. The test was considered positive if significant defects
that were either fixed or reversible were revealed on delayed imaging, based on
circumferential count profile analysis.
Echocardiography
• Resting wall motion abnormality
Resting ECG
• ECGs evaluated for evidence of MI, abnormal ST-T changes, and left ventricular
hypertrophy. Evidence of MI was regarded as positive if significant Q waves were
present in more than one lead. ST-T segment abnormality was noted as present if ST-
segment depression or elevation of at least 1 mm; or inverted T wave in any lead where
the QRS complex had a net positive deflection were detected in the absence of bundle
branch block and left ventricular hypertrophy.
Follow-up Survival data are available.

Notes All patients underwent coronary angiography, echocardiography and resting ECG. 19
patients underwent dipyridamole MPS

Table of Methodological Quality

Item Authors’ judgement Description

Representative spectrum? Yes Patients with DM who were candidates for
All tests kidney transplant.

Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 52
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.