Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
1999-6-22
pubmed:abstractText
Prophylactic coronary revascularization may reduce the risk for cardiac events in diabetic renal transplant candidates. No published data exist on the accuracy of dobutamine stress echocardiography (DSE) for the diagnosis of angiographically defined coronary artery disease (CAD) in renal transplant candidates. The purpose of this study is to examine the accuracy of DSE for the detection of CAD in high-risk renal transplant candidates compared with coronary angiography. Fifty renal transplant candidates with diabetic nephropathy (39 patients) or end-stage renal disease (ESRD) from other causes (11 patients) underwent prospectively performed DSE, followed by quantitative coronary angiography (QCA) and qualitative visual assessment of CAD severity. Twenty of 50 DSE tests were positive for inducible ischemia. Twenty-seven patients (54%) had a stenosis of 50% or greater by QCA, 12 patients (24%) had a stenosis of greater than 70% by QCA, and 16 patients (32%) had a stenosis greater than 75% by visual estimation. The sensitivity and specificity of DSE for CAD diagnosis were respectively 52% and 74% compared with QCA stenosis of 50% or greater, 75% and 71% compared with QCA stenosis greater than 70%, and 75% and 76% for stenosis greater than 75% by visual estimate. On long-term follow-up (22.5 +/- 10.1 months), 6 of 30 patients (20%) with negative DSE results and 11 of 20 patients (55%) with positive DSE results had a cardiac death, myocardial infarction (MI), or coronary revascularization. Six of 27 patients (22%) with a QCA stenosis of 50% or greater had a cardiac death or MI compared with none of the 23 patients (0%) with QCA stenosis less than 50% (P = 0.025). We conclude that DSE is a useful but imperfect screening test for angiographically defined CAD in renal transplant candidates.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1523-6838
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
33
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
1080-90
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:10352196-Adult, pubmed-meshheading:10352196-Aged, pubmed-meshheading:10352196-Cardiotonic Agents, pubmed-meshheading:10352196-Coronary Angiography, pubmed-meshheading:10352196-Coronary Disease, pubmed-meshheading:10352196-Diabetic Nephropathies, pubmed-meshheading:10352196-Dobutamine, pubmed-meshheading:10352196-Echocardiography, Doppler, pubmed-meshheading:10352196-Electrocardiography, pubmed-meshheading:10352196-Female, pubmed-meshheading:10352196-Follow-Up Studies, pubmed-meshheading:10352196-Humans, pubmed-meshheading:10352196-Kidney Failure, Chronic, pubmed-meshheading:10352196-Kidney Transplantation, pubmed-meshheading:10352196-Male, pubmed-meshheading:10352196-Middle Aged, pubmed-meshheading:10352196-Postoperative Complications, pubmed-meshheading:10352196-Sensitivity and Specificity
pubmed:year
1999
pubmed:articleTitle
Dobutamine stress echocardiography for the detection of significant coronary artery disease in renal transplant candidates.
pubmed:affiliation
Department of Internal Medicine, Hennepin County Medical Center, Minneapolis, MN, Australia. herzo003@maroon.tc.umn.edu
pubmed:publicationType
Journal Article, Clinical Trial, Comparative Study, Research Support, Non-U.S. Gov't