Diagnostic Noninvasive Tests for Coronary Artery Disease in Chronic Renal Failure Patients.
- Author:
Woo Kyun BAE
1
;
Ok Ki KIM
;
Min Ho SHIN
;
Hak WOO
;
Yoon Chul LEE
;
Young Wook CHO
;
Youn Kyoung LEE
;
Min Seok CHO
;
Seong Kwon MA
;
Soo Wan KIM
;
Nam Ho KIM
;
Myung Ho JEONG
;
Ki Chul CHOI
Author Information
1. Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Korea. nhk@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Chronic kidney failure;
Coronary disease;
Troponin;
Echocardiography
- MeSH:
Cause of Death;
Coronary Angiography;
Coronary Artery Disease*;
Coronary Disease;
Coronary Vessels*;
Diagnosis;
Echocardiography;
Electrocardiography;
Humans;
Kidney Failure, Chronic*;
Mass Screening;
Myocardial Ischemia;
Peritoneal Dialysis;
Renal Dialysis;
Retrospective Studies;
Sensitivity and Specificity;
Technetium;
Tomography, Emission-Computed, Single-Photon;
Troponin;
Troponin T
- From:Korean Journal of Nephrology
2005;24(3):407-413
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: As ischemic heart disease is the major cause of death in chronic renal failure patients, screening tests are clinically important. Although coronary angiography is considered the gold standard for the diagnosis of coronary artery disease, other noninvasive tests are usually used to avoid this potentially dangerous and costly procedure. METHODS: We retrospectively determined the sensitivity, specificity, and positive and negative predictive values for electrocardiography, echocardiography, cardiac enzyme determination, and Technetium 99m tetrofosmin (TF) single photon emission computed tomography (SPECT) in 61 chronic renal failure patients who underwent coronary angiography. RESULTS: Nineteen patients (31.1%) were undergoing chronic hemodialysis, seven patients (11.4%) were undergoing peritoneal dialysis, and thirty five patients (57.3%) were undergoing conservative treatment. 99mTc SPECT had a sensitivity of 96% and specificity of 19%. Although echocardiography and tronponin-T had a relatively lower sensitivity of 69 % and 56% than 99mTc SPECT, they had a higher specificity of 63% and 63%, respectively. 99mTc SPECT had the highest sensitivity of 88% and echocardiography had the highest specificity of 78% in renal replacement group. 99mTc SPECT had the highest sensitivity of 100% and Troponin T had the highest specificity of 71% in conservative treatment group. CONCLUSION: Noninvasive test for coronary artery disease in patients with chronic renal failure, especially 99mTc SPECT is of limited value because of their low specificity, so echocardiography and troponin T may helpful for diagnosing coronary artery disease.
