Dobutamine stress echocardiography and cardiac troponin T for the detection of significant coronary artery disease and predicting outcome in renal transplant candidates

Aims: Ischaemic heart disease is the leading cause of mortality and morbidity in patients with end-stage renal disease (ESRD) and after renal transplantation. However, the optimal non-invasive test for coronary artery disease (CAD) diagnosis in this population has yet to be established. The aim of this study was to assess the diagnostic accuracy of dobutamine stress echocardiography (DSE) and baseline plasma cardiac troponin T (cTnT) for detecting significant CAD and predicting adverse cardiac events in patients referred for renal transplantation. Methods: Coronary angiography, DSE, and baseline cTnT measurements were performed in 118 consecutive patients (mean age 52 G 12 years, 75 male) with ESRD (mean creatinine 608G 272 mmol/L) referred for renal transplantation. The mean follow-up period was 1.32 G 0.48 years. Significant CAD was defined as a reduction in luminal diameter O70% by visual estimation in at least one major epicardial vessel. An abnormal DSE result defined as the development of a new regional wall motion abnormality in one or more normal resting segments or a deterioration of wall motion in one or more resting hypokinetic segments. A baseline cTnT O0.1 mg/L was taken as positive.