The association of preoperative cardiac stress testing with 30-day death and myocardial infarction among patients undergoing kidney transplantation

BACKGROUND:Although periodic cardiac stress testing is commonly used to screen patients on the waiting list for kidney transplantation for ischemic heart disease, there is little evidence to support this practice. We hypothesized that cardiac stress testing in the 18 months prior to kidney transplantation would not reduce postoperative death, total myocardial infarction (MI) or fatal MI. METHODS:Using the United States Renal Data System, we identified ESRD patients ≥40 years old with primary Medicare insurance who received their first kidney transplant between 7/1/2006 and 11/31/2013. Propensity matching created a 1:1 matched sample of patients with and without stress testing in the 18 months prior to kidney transplantation. The outcomes of interest were death, total (fatal and nonfatal) MI or fatal MI within 30 days of kidney transplantation. RESULTS:In the propensity-matched cohort of 17,304 patients, death within 30 days occurred in 72 of 8,652 (0.83%) patients who underwent stress testing and in 65 of 8,652 (0.75%) patients who did not (OR 1.07; 95% CI: 0.79-1.45; P = 0.66). MI within 30 days occurred in 339 (3.9%) patients who had a stress test and in 333 (3.8%) patients who did not (OR 1.03; 95% CI: 0.89-1.21; P = 0.68). Fatal MI occurred in 17 (0.20%) patients who underwent stress testing and 15 (0.17%) patients who did not (OR 0.97; 95% CI: 0.71-1.32; P = 0.84). CONCLUSION:Stress testing in the 18 months prior to kidney transplantation is not associated with a reduction in death, total MI or fatal MI within 30 days of kidney transplantation

New distant companions to known nearby stars: I. GJ 4047B, GJ 718B, GJ 747.2C, GJ 4100B, and GJ 4153B

In an ongoing survey for high proper motion stars at low galactic latitudes, we have identified 5 previously uncatalogued common proper motion companions to stars listed in the Preliminary Version of the Third Catalogue of Nearby Stars (GJ stars). For each system, the relative proper motion between the components is less than 5% of the common proper motion of the pair. Spectra of the pairs have been obtained at the Lick 3-m Shane Telescope, confirming that the systems are indeed wide separation binaries. The systems are classified as follows: GJ 4047AB = K5 V + M5 V, GJ 718AB = K5 V + M4.5 V, GJ 747.2ABC = (K7 V + K7 V) + M4 Ve, GJ 4100AB = M1 V + M4.5 Ve, and GJ 4153AB = M0.5 V + M3.5 V. The total area surveyed contains 346 Gliese stars, which suggests that approximately 1.5% of the stars listed in the Preliminary Version of the Third Catalogue of Nearby Stars have unrecognized proper motion companions. We predict that 15-50 more new distant companions to GJ stars will be discovered in the Digitized Sky Survey.Comment: 15 page, 5 figures, 2 tables, to appear in The Astronomical Journa

Cool White Dwarfs Revisited -- New Spectroscopy and Photometry

In this paper we present new and improved data on 38 cool white dwarfs identified by Oppenheimer et al. 2001 (OHDHS) as candidate dark halo objects. Using the high-res spectra obtained with LRIS, we measure radial velocities for 13 WDs that show an H alpha line. We show that the knowledge of RVs decreases the UV-plane velocities by only 6%. The radial velocity sample has a W-velocity dispersion of sig_W = 59 km/s--in between the values associated with the thick disk and the stellar halo. We also see indications for the presence of two populations by analyzing the velocities in the UV plane. In addition, we present CCD photometry for half of the sample, and with it recalibrate the photographic photometry of the remaining WDs. Using the new photometry in standard bands, and by applying the appropriate color-magnitude relations for H and He atmospheres, we obtain new distance estimates. New distances of the WDs that were not originally selected as halo candidates yield 13 new candidates. On average, new distances produce velocities in the UV plane that are larger by 10%, with already fast objects gaining more. Using the new data, while applying the same UV-velocity cut (94 km/s) as in OHDHS, we find a density of cool WDs of 1.7e-4 pc^-3, confirming the value of OHDHS. In addition, we derive the density as a function of the UV-velocity cutoff. The density (corrected for losses due to higher UV cuts) starts to flatten out at 150 km/s (0.4e-4 pc^-3), and is minimized (thus minimizing a possible non-halo contamination) at 190 km/s (0.3e-4 pc^-3). These densities are in a rough agreement with the estimates for the stellar halo WDs, corresponding to a factor of 1.9 and 1.4 higher values.Comment: Accepted to ApJ. New version contains some additional data. Results unchange