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Diagnostic Performance of Coronary CT Angiography With CT FFR in Kidney Transplantation Candidates

Patients with chronic kidney disease (CKD) before kidney transplantation require that obstructive coronary artery disease (CAD) is excluded, as cardiovascular complications are the leading cause of mortality in kidney transplant patients. However, in this patient population, the optimal method for the detection of obstructive CAD has not been identified. Noninvasive stress tests such as Dobutamine stress echocardiography or nuclear perfusion study have low diagnostic accuracy. CT fractional flow reserve measurement (CT FFR) is a novel non-invasive (FDA approved) imaging test to identify obstructive CAD. The goal of this project is to evaluate the diagnostic accuracy of CT FFR in the detection of obstructive coronary artery disease in patients with chronic kidney disease before kidney transplantation.

Stanford is currently not accepting patients for this trial.

Stanford Investigator(s):

Intervention(s):

  • diagnostic test: CT FFR

Eligibility


Inclusion Criteria:

   - Candidates for kidney transplantation on dialysis without any residual kidney function
   AND referred to invasive coronary angiography for cardiac evaluation

   - Referral to invasive coronary angiography is based on algorithm used at the Transplant
   Readiness Assessment Clinic (TRAC) at Stanford:

   - A. Diabetic Candidates older than 45 years.

   - B. Diabetic Candidates under 45 years old and any one of the following criteria is
   present:

   - a) 25 year History of Diabetes

   - b) 5 year Smoking History

   - c) Abnormal EKG (ST-T wave changes)

Exclusion Criteria:

   - Hemodynamically and clinically unstable condition (angina at rest, malignant
   arrhythmias)

   - Known ischemic heart disease (prior, documented myocardial infarction, prior stenting
   or coronary artery bypass graft surgery)

   - BMI>30 kg/m2, or weight >120 kg.

   - Atrial fibrillation or other arrhythmia, >6 ectopic beats per minute

   - Known or suspected allergy to iodinated contrast medium

   - Pregnancy cannot be excluded

Ages Eligible for Study

21 Years - N/A

Genders Eligible for Study

All

Not currently accepting new patients for this trial

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Dominik Fleischmann, MD
650-723-7647
Not Recruiting