Comparative Effectiveness of Positron Emission Tomography (PET) and Single-photon Emission Computed Tomography (SPECT) Myocardial Perfusion Imaging (MPI) for Predicting Cardiovascular Events After Kidney Transplant
Authors' conclusion
Kidney transplant recipients are at high cardiovascular risk, despite a minority having obstructive coronary artery disease on MPI. PET MPI findings predict posttransplant MACE.
Study context
- Population
- Patients undergoing MPI before kidney transplant58 [15%] abnormal MPI
- Participants
- 393 patients
- Exposure
- Pretransplant PET MPI vs SPECT MPI for predicting posttransplant MACE
- PETn = 208
- SPECTn = 185
- Outcome
- Posttransplant MACE (MI, stroke, HF, cardiac death); abnormal MPI = total perfusion deficit >5% of myocardium
- Follow-up
- Median 5.9 years
Methodological detailspropensity-weighted
- Propensity-weighted
Main finding
As reported in the abstract
Association of abnormal MPI with posttransplant MACE
Hazard ratio (95% CI)P value
Abnormal PETvs Normal PET
3.02(1.78–5.11)
P < 0.001Abnormal SPECTvs Normal SPECT
1.39(0.72–2.66)
P = 0.33- Explained relative risk (R2), PET vs SPECT
- 0.086 versus 0.007
Observational data: associations, not effects.
Further findings
| Outcome | PET | SPECT | P value |
|---|---|---|---|
| MACE rate with normal MPINormal results | 2.2%/year | 3.6%/year | P < 0.001 |
Original publication
Comparative Effectiveness of PET and SPECT MPI for Predicting Cardiovascular Events After Kidney Transplant. Circ Cardiovasc Imaging. Published 16 January 2024. doi:10.
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