Patients with chronic kidney disease (CKD) have a markedly increased cardiovascular risk, with coronary artery disease being a leading cause of morbidity and mortality. Conventional cardiovascular risk scores and non-invasive diagnostic tests have limited accuracy in this population, partly due to atypical symptoms and frequent structural heart disease. Coronary flow reserve (CFR) is a key marker of coronary microvascular dysfunction and has strong prognostic value, but its assessment is usually limited to invasive techniques. Recent advances in cadmium-zinc-telluride single-photon emission computed tomography (CZT-SPECT) allow non-invasive measurement of CFR. The EVACKD study aims to evaluate the prognostic value of CFR assessed by CZT-SPECT in patients with CKD for predicting major adverse cardiovascular events over a 2-year follow-up.
Study Type
OBSERVATIONAL
Enrollment
283
CHU Grenoble Alpes
La Tronche, France, France
To assess the prognostic value of impaired coronary flow reserve measured by CZT myocardial perfusion imaging
Composite endpoint including cardiac mortality, non-fatal myocardial infarction, non-fatal ischemic stroke, and hospitalization for heart failure.
Time frame: 2-year follow-up
To assess the prognostic value of coronary flow reserve to each individual component of the primary endpoint
To evaluate each component separately : Cardiac mortality rate, non-fatal myocardial infarction rate, non-fatal ischemic stroke rate, hospitalization rate for heart failure, and all-cause mortality rate.
Time frame: 2 years
To assess the prognostic value of coronary flow reserve for Major Adverse Kidney Events (MAKE)
Rate of patients with Major Adverse Kidney Events (MAKE), defined by the composite endpoint of death, dependence on renal replacement therapy, and a ≥50% decline in estimated glomerular filtration rate (eGFR) from baseline
Time frame: At 1-year and 2-year follow-up
To assess the number of Acute Kidney Injury (AKI) events during follow-up
Evaluation of the Acute Kidney Injury (AKI) rate classified into three grades: Grade 1 (1.5- to 2-fold increase in serum creatinine), Grade 2 (2- to 3-fold increase), and Grade 3 (\>3-fold increase or need for dialysis)
Time frame: 2 years
To assess the number of coronary revascularizations by coronary artery bypass grafting or percutaneous coronary intervention
Performed by calculating the rate of revascularization by coronary artery bypass grafting or percutaneous coronary intervention
Time frame: 2 years
To assess the prevalence of ischemic heart disease without significant coronary artery stenosis (INOCA)
Rate of ischemic heart disease without significant coronary artery stenosis (INOCA)
Time frame: 2 years
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