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Titolo:
Pre-transplant cardiac testing for kidney-pancreas transplant candidates and association with cardiac outcomes
Autore:
Lin, K; Stewart, D; Cooper, S; Davis, CL;
Indirizzi:
Univ Washington, Med Ctr, Dept Med, Div Nephrol, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 , Div Nephrol, Seattle, WA 98195 USA
Titolo Testata:
CLINICAL TRANSPLANTATION
fascicolo: 4, volume: 15, anno: 2001,
pagine: 269 - 275
SICI:
0902-0063(200108)15:4<269:PCTFKT>2.0.ZU;2-W
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOBUTAMINE STRESS ECHOCARDIOGRAPHY; CORONARY-ARTERY DISEASE; RENAL-TRANSPLANTATION; CARDIOVASCULAR-DISEASE; RISK-FACTORS; COMPLICATIONS; ANTIOXIDANTS;
Keywords:
coronary disease; kidney-pancreas transplantation; risk assessment; risk factors;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
22
Recensione:
Indirizzi per estratti:
Indirizzo: Lin, K Box 356174,1959 NE Pacific St, Seattle, WA 98195 USA Box 356174,1959 NE Pacific St Seattle WA USA 98195 e, WA 98195 USA
Citazione:
K. Lin et al., "Pre-transplant cardiac testing for kidney-pancreas transplant candidates and association with cardiac outcomes", CLIN TRANSP, 15(4), 2001, pp. 269-275

Abstract

Background: Coronary artery disease is a major cause of mortality following renal transplantation, especially in those patients with diabetes The accurate prediction of cardiac risk is therefore a major focus of the pre-transplant evaluation. The objective of this, study was to retrospectively evaluate the ability of non-invasive cardiac testing (standard echocardiography, stress echocardiography, exercise tolerance testing, and nuclear myocardial perfusion) performed within 1 yr of kidney-pancreas transplant to predict post-transplant myocardial infarction. Methods: Clinical history and pre-transplant cardiac testing performed within 1 yr prior to transplantation were reviewed in a non-blinded fashion for 165 kidney-pancreas transplantation patients receiving allografts betweenJune 1990 and May 1998. The predictive values of clinical symptoms and cardiac testing for cardiac events (fatal and non-fatal myocardial infarctions) up to 1 yr post-transplant were calculated. Results: Clinical history had a negative predictive value of 98% for cardiac events occurring within 1 yr following testing and 97% within I yr post-transplant. Collectively, non-invasive testing had a negative predictive value of 97% for 1 yr post-testing and 1 yr post-transplant. Conclusion: Clinical history alone is highly suggestive but not sufficientfor the prediction of post-kidney-pancreas transplant myocardial infarction. Although a useful supplement, cardiac testing does not predict all cardiac events out to 1 yr post-testing. In this high-risk patient population with diabetes and renal failure, other methods of risk assessment are needed to more accurately predict long-term cardiac outcome for patients awaiting transplantation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/11/20 alle ore 02:53:11