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Imaging Shows Risk of Cardiac Events in Dialysis Patients

Technique uses a tracer of myocardial fatty acid metabolism

WEDNESDAY, Jan. 9 (HealthDay News) -- Computed tomography using a radioactive tracer of myocardial fatty acid metabolism can identify those at high risk of cardiac events among asymptomatic hemodialysis patients, according to a study in the Jan. 15 issue of the Journal of the American College of Cardiology.

Masato Nishimura, M.D., Ph.D., from Toujinkai Hospital in Kyoto, Japan, and colleagues assessed whether single-photon emission computed tomography using iodine-123 beta-methyl-iodophenyl-pentadecanoic acid (BMIPP) and 201-thallium chloride could detect coronary artery disease with high sensitivity in 318 asymptomatic hemodialysis patients.

During a median follow-up of 3.6 years, the researchers found that 50 patients died of cardiac events. Patients who were older (aged 70 or over, hazard ratio 2.4) or had severely abnormal images (BIMPP summed scores of 12 or more, hazard ratio 21.9) were at significantly higher risk of cardiac events. The event-free rate of cardiac death decreased with increasing BMIPP summed scores, with a three-year rate of 61 percent for patients with BMIPP scores of 12 or more and a rate of 98 percent for patients with BMIPP scores less than 12.

"Targeting intracellular metabolic processes for imaging may expand our ability to diagnose and treat subclinical myocardial ischemia or progressive cardiomyopathy that often remains elusive with traditional imaging approaches," Vasken Dilsizian, M.D., and Jeffrey C. Fink, M.D., from the University of Maryland School of Medicine in Baltimore, write in an accompanying editorial.

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