Evidence map›Paper›PMID 28050863›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2018

Incremental prognostic value of SPECT-MPI in chronic kidney disease: A reclassification analysis.

Amjad M Ahmed, Waqas T Qureshi, Wesley T O'Neal, Fatima Khalid, Mouaz H Al-Mallah

Abstract read
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Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. The role of cardiac imaging in the management of non-ischemic cardiovascular diseases in human immunodeficiency virus infection.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2020
    Article
  3. Regadenoson use in chronic kidney disease and end-stage renal disease: A focused review.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2018
    Review
  4. Review
  5. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 2 countries.

Amjad M AhmedKing Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, P.O. Box 22490, Riyadh, 11426, Saudi Arabia.
Waqas T QureshiDepartment of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA.
Wesley T O'NealDepartment of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA.
Fatima KhalidDepartment of Internal Medicine, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC, USA.
Mouaz H Al-MallahKing Abdulaziz Cardiac Center, King Abdulaziz Medical City, Ministry of National Guard-Health Affairs, P.O. Box 22490, Riyadh, 11426, Saudi Arabia. mouaz74@gmail.com.
Wake Forest University · USKing Saud bin Abdulaziz University for Health Sciences · SANational Guard Health Affairs · SA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTraditional cardiovascular (CV) risk factors have limited predictive value of CV mortality in patients with chronic kidney disease (CKD, creatinine clearance less than 60 mL/minute per 1.73 m

methodsWe retrospectively studied 11,518 (mean age, 65 ± 12 years; 52% were men) patients referred for a clinical indication of SPECT-MPI between April 2004 and May 2009. Primary end point was composite of cardiac death and non-fatal myocardial infarction (CD/MI). We examined the relationship of total perfusion defect (TPD) and CD/MI in multiple Cox regression models for CV risk factors and GFR. The incremental predictive value of TPD was examined using Harrell's c-index, net reclassification index (NRI), and integrated discrimination index (IDI).

resultsOver a median follow-up of 5 years (25th to 75th percentiles, 3.0-6.5 years), 1,692 (14.5%) patients experienced CD/MI (740 MI and 1,182 CD). In a multivariable model adjusted for traditional CV risk factors and GFR, the presence of a perfusion defect was independently associated with increased risk of CD/MI (HR = 2.10; 95% CI 1.81, 2.43, p < .001). Using Cox regression, TPD improved the discriminatory ability beyond traditional CV risk factors and GFR [from AUC = 0.725, (95% CI 0.712-0.738) to 0.784, (95% CI 0.772-0.796), p < .0001]. Furthermore, TPD improves risk stratification of CKD patients over and above traditional CV risk factors and GFR [NRI = 14%, 95% CI (12%-16%, p < .001) and relative IDI = 60%, 95% CI (51%, 66%, p < .001)].

conclusionsAcross the spectrum of renal function, SPECT-MPI perfusion defects independently and incrementally reclassified patients for their risk of CD/MI, beyond traditional CV risk factors.

Indexed as

DeathAgedAged, 80 and overFemaleHumansMaleMiddle AgedMyocardial InfarctionMyocardial Perfusion ImagingPrognosisRenal Insufficiency, ChronicRetrospective StudiesRisk FactorsTomography, Emission-Computed, Single-Photoncardiovascular deathchronic kidney diseasemyocardial infarctionperfusion defectsrisk reclassificationSPECT-MPI

Identifiers

PMID28050863
OpenAlexW2565915071

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.