Key result
Application of four national guidelines to renal transplant candidates resulted in recommended cardiac stress testing rates ranging from 20% with ACC/AHA to 100% with KDOQI (P<0.0005).
Why the study?
Does the choice of preoperative cardiac evaluation guideline affect the rate of stress testing and detection of ischemia in asymptomatic renal transplant candidates?
Population
204 asymptomatic renal transplant candidates without active cardiac conditions, mean age 52, 62% male…
Comparison
Retrospective application of four preoperative… vs Comparison among the four guidelines.
Design
Cohort
Authors
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Guideline choice drives wide variation in stress testing rates for renal transplant candidates; leaves open optimal strategy to balance detection and overtesting.
Observational (n=204)
No
Does the choice of preoperative cardiac evaluation guideline affect the rate of stress testing and detection of ischemia in asymptomatic renal transplant candidates?
Absolute Event Rate: 20% vs 100%
p-value: p=<0.0005
Renal transplant-specific guidelines recommend significantly more preoperative cardiac stress testing than ACC/AHA guidelines, identifying more ischemia but potentially leading to overtesting.
Friedman et al. (2011) conducted an observational in End-stage renal disease (renal transplant candidates) (n=204). Preoperative cardiac evaluation guidelines (ACC/AHA, KDOQI, AST, Lisbon) vs. Between-guideline comparison was evaluated on Recommended rate of preoperative cardiac evaluation (ACC/AHA vs KDOQI) (p=<0.0005). Application of four national guidelines to renal transplant candidates resulted in recommended cardiac stress testing rates ranging from 20% with ACC/AHA to 100% with KDOQI (P<0.0005).
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