Page 71 - Cardiac testing for coronary artery disease in potential kidney transplant recipients

Sharma 2005 (Continued)

blood pressure > 30 mm Hg, SBP rise > 230 mm Hg occurred. Patients were given an
angina score: 0 = none, 1 = non-limiting angina, 2 = limiting angina. Duke score was
calculated as: total treadmill time (min)-5 X magnitude of maximal ST depression
(mm)- 4 X angina index. Horizontal or down sloping ST depression > 1mm measured
80 ms after the J point, and ST elevation > 1 mm measured 40 ms after the J point,
were regarded as positive results. The test was described as inconclusive if stopped
before 85% predicted heart rate could be achieved with no cardiac symptoms or
significant changes at that stage.
• DSE
◦ An abnormal response was described as the occurrence under stress of
hypokinesia, akinesia or dyskinesia in one or more resting normal segments and/or
worsening of wall motion in one or more resting hypokinetic segments.
• Echocardiography
• Mitral annular calcification
◦ The presence of mitral annular calcification was defined as an echo dense
band visualised throughout systole and diastole, distinguishable from the posterior
mitral valve leaflet, and located anterior and parallel to the posterior left ventricular
wall on M-mode recordings.
• Resting wall motion abnormality
• Resting ECG
◦ The ECG was considered abnormal if any of the following criteria were met
in any of the standard limb leads or precordial leads, except AVR or V1: pathological Q
waves, left ventricular hypertrophy by Sokolow-Lyon criteria or Cornell index, ST
depression ≥ 1 mm, ST elevation ≥ 1 mm, T wave inversion or bundle branch block
(QRS ≥120 ms).

Follow-up Patients were followed up for 1.32 ± 0.48 years (range 0.19 ± 2.12 years)

Notes

Table of Methodological Quality

Item Authors’ judgement Description

Representative spectrum? Yes ESKD patients undergoing cardiac evalua-
All tests tion as part of transplant workup

Acceptable reference standard? Yes Coronary angiography with a reference
All tests standard threshold of ≥ 70% stenosis

Acceptable delay between tests? Unclear Likely to be short delay between tests.
All tests

Partial verification avoided? Yes All participants who underwent the index
All tests test 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) 69
Copyright © 2011 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.