Cardiac event risk in Japanese subjects estimated using gated myocardial perfusion imaging, in conjunction with diabetes mellitus and chronic kidney disease

Kenichi Nakajima, Shinro Matsuo, Chio Okuyama, Tsuguru Hatta, Kazumasa Tsukamoto, Shigeyuki Nishimura, Akira Yamashina, Hideo Kusuoka, Tsunehiko Nishimura

Research output: Contribution to journalArticle

Abstract

Background: Cardiac event risk is estimated using quantitative gated myocardial perfusion imaging (MPI) and clinical background in patients with ischemic heart disease. The aim of the present study was to calculate major cardiac event risk and tabulate it in the Heart Risk Table for clinical use of risk stratification. Methods and Results: Multivariate logistic regression was performed based on a multicenter prognostic database (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated Single-photon emission computed tomography [J-ACCESS investigation]) using MPI (n=2,395). The risk of major cardiac events (cardiac death, non-fatal myocardial infarction and heart failure requiring hospitalization) was estimated using age, ejection fraction (EF), estimated glomerular filtration rate (eGFR) and presence of diabetes mellitus (DM). Age-matched standard eGFR was determined in 77 subjects. Major cardiac event risk was calculated using the equation: risk (%/3 years) = 1/(1 + Exp(-(-4.699-0.0151 × eGFR + 0.7998 × DM + 0.0582 × age + 0.697 × SSS-0.0359 × EF)) × 100, where SSS refers to summed stress scores. Risk was determined without eGFR (the initial version) and using the present formula with eGFR (revised version), with consistent results. DM and chronic kidney disease were major determinants of cardiac events. Conclusions: Cardiac event risk was estimated using MPI defect score and left ventricular EF in conjunction with eGFR and the presence of DM. The risk table might be used for risk evaluation in Japanese patients undergoing MPI.

Original languageEnglish (US)
Pages (from-to)168-175
Number of pages8
JournalCirculation Journal
Volume76
Issue number1
DOIs
StatePublished - Jan 2012

Keywords

  • Cardiac event
  • Chronic kidney disease
  • Diabetes mellitus
  • Myocardial perfusion imaging
  • Risk stratification

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Nakajima, K., Matsuo, S., Okuyama, C., Hatta, T., Tsukamoto, K., Nishimura, S., Yamashina, A., Kusuoka, H., & Nishimura, T. (2012). Cardiac event risk in Japanese subjects estimated using gated myocardial perfusion imaging, in conjunction with diabetes mellitus and chronic kidney disease. Circulation Journal, 76(1), 168-175. https://doi.org/10.1253/circj.CJ-11-0857