Page 69 - Cardiac testing for coronary artery disease in potential kidney transplant recipients

Rosario 2010 (Continued)

Target condition and reference standard(s) Coronary artery stenosis measured by coronary angiography
• CAD defined as presence of ≥ 1 coronary arteries with ≥ 70% diameter stenosis.

Index and comparator tests Multi-detector CT exams
• Performed in 16 and 64-column detector-row. Patients’ heart rates during
examination = 61.1 ± 6.9 bpm. Patients with rates > 70 bpm on arrival for CT scan
received IV beta-blocker (metoprolol)to achieve 60 bpm, or the maximum dose (15
mg), since the protocol included associated coronary angiotomography acquisition.
Calcium score obtained through prospective acquisition, and synchronised to ECG
tracing. Images acquired were 3.0 mm thick, and view field was from 200 to 220 mm
for chest axial images covering all cardiac area and allowing visualisation of coronary
arteries and possible calcification on coronary artery topography. Images were acquired
at a diastolic moment that was defined following patient’s heart rate.

Follow-up Follow-up ongoing.

Notes

Table of Methodological Quality

Item Authors’ judgement Description

Representative spectrum? Yes CKD patients already in a haemodialysis
All tests program and referred to be submitted to
kidney transplant

Acceptable reference standard? Yes Yes, coronary angiography with a reference
All tests standard threshold of ≥ 50 and 70% steno-
sis

Acceptable delay between tests? Yes Time elapsed between Multi-detector CT
All tests and coronary angiography was on average
99.03 days, SD 87.65 days, and median 79
days. Minimum interval was 2 days, and
maximum interval was 380 days. Only 2
cases exceeded 1 year, and 16 cases had an
interval over 6 months

Partial verification avoided? Yes All participants who received an index test
All tests received the reference standard test

Differential verification avoided? Yes This was not an issue in this study. Disease
All tests status (CAD) is diagnosed only through
coronary angiography

Incorporation avoided? Yes This was not an issue in this study. Disease
All tests status (CAD) is diagnosed only through
coronary angiography

Cardiac testing for coronary artery disease in potential kidney transplant recipients (Review) 67
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.