Dipyridamole stress echocardiography in diagnosis and prognosis of hemodialysis patients with asymptomatic coronary disease

Rodolfo F. Rivera, Luca Mircoli, Giuseppe Bonforte, Valter Torri, Marta Monteforte, Andrea Stella, Simonetta Genovesi

Research output: Contribution to journalArticle

Abstract

The prevalence of coronary artery disease (CAD) is high in hemodialysis (HD) patients. The aim of the study was to assess the diagnostic and prognostic value of dipyridamole stress echocardiography (DSE) in nondiabetic HD patients without signs or symptoms of CAD. In 51 out of 158 evaluated HD patients (21 females, age 67 [33-85] years, HD duration 38 [9-271] months), resting echocardiography and DSE were performed. Exclusion criteria were known CAD, diabetes mellitus, and pulmonary and oncologic pathologies. Logistic regression analysis was carried out to identify predictors of abnormal DSE response, while Cox regression analysis was performed to determine variables associated with total and cardiovascular mortality, after 43.3 (11-60) months of follow-up. Seven patients (14%) showed a positive response to DSE (DSE+). In 5/7, CAD was documented by angiography: All of them underwent coronary revascularization. DSE+ patients had significantly smaller body mass index than patients with a negative response (DSE-): 21.7±1.9 vs. 25.1±3.4kg/m 2 (p=0.018). During follow-up, 16 (31%) patients died. Older age hazard ratio [HR=1.07; confidence interval (CI)=1.01-1.12; p=0.02] and higher plasma phosphate levels (HR=10.41; CI=2.30-47.17; p

Original languageEnglish
Pages (from-to)468-476
Number of pages9
JournalHemodialysis International
Volume15
Issue number4
DOIs
Publication statusPublished - Oct 2011

Keywords

  • Cardiovascular mortality
  • Coronary artery disease
  • Dipyridamole stress echocardiography
  • Hemodialysis
  • Total mortality

ASJC Scopus subject areas

  • Hematology
  • Nephrology

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