Kidney Week

Abstract: SA-PO941

Accuracy of Myocardial Perfusion Imaging (MPI) in Predicting Post-transplant Cardiovascular Events among Asymptomatic Diabetic Kidney Transplant Candidates

Session Information

• Transplantation: Clinical - 3
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Transplantation

• 2102 Transplantation: Clinical

Authors

• Mohsin, Bilal, King Faisal Specialist Hospital and Research Centre - Jeddah, Jeddah, Saudi Arabia

Bilal Mohsin, MD, MBBS

• Alfi, Yasir, King Faisal Specialist Hospital and Research Centre - Jeddah, Jeddah, Saudi Arabia

Yasir Alfi, MBBS

• Alaydarous, Shahad, King Faisal Specialist Hospital and Research Centre - Jeddah, Jeddah, Saudi Arabia

Shahad Alaydarous

• Alhowaiti, Naief Mohammad S, King Faisal Specialist Hospital and Research Centre - Jeddah, Jeddah, Saudi Arabia

Naief Mohammad S Alhowaiti, MBBS

• Odah, Nasser Omran, King Faisal Specialist Hospital and Research Centre - Jeddah, Jeddah, Saudi Arabia

Nasser Omran Odah

• Habhab, Wael Taher, King Faisal Specialist Hospital and Research Centre - Jeddah, Jeddah, Saudi Arabia

Wael Taher Habhab, MD

Background

Cardiovascular risk assessment is crucial prior to kidney transplantation especially in diabetic patients as nearly 6.6% of recipients have a major adverse cardiovascular event (MACE) within 3 years. This study aims to evaluate the predictive role of MPI among asymptomatic diabetic candidates for post-kidney transplant cardiovascular events.

Methods

This is a retrospective, single center study. We included adult diabetic patients who underwent MPI prior to kidney transplant with a post kidney transplant follow up of 2 years. The primary outcome was a composite of death, ACS, coronary revascularization, hospitalization for heart failure (ADHF), and CVA. These were also studied individually as secondary outcomes. Sensitivity, specificity, PPV and NPV for MPI in detecting obstructive CAD were evaluated in candidates that underwent pre-transplant coronary angiography.

Results

Out of 121 candidates, 76 had normal-MPI and 45 had abnormal-MPI. Primary composite outcome was seen in 9 pateints (11.8%) in the normal-MPI group and in 4 (8.9%) in the abnormal-MPI group. More patients in abnormal-MPI group had ADHF (not statistically significant). Out of the 4 normal-MPI patients that had ACS, 3 required post-transplant revascularization, 2 of them did not undergo pre-transplant coronary angiography. In normal-MPI patients, 55 underwent pre-transplant coronary angiography, 8 of them had obstructive CAD. MPI had a sensitivity, specificity, NPV and PPV of 60%, 59.7%, 85% and 27.9% respectively in identifying obstructive CAD as compared to pre-transplant coronary angiography.

Conclusion

Diabetic candidates with abnormal-MPI had similar incidence of mortality and MACE post-kidney transplant as compare to normal-MPI patients. MPI had a NPV of 85% in ruling out obstructive CAD. The predictive role of MPI pre kidney transplant remains unclear and needs further study.

* Significance of Fisher’s Exact test