Document Detail


[Incidence and prognostic value of ischemic heart disease in high risk cardiovascular asymptomatic diabetic patients detected by gated myocardial perfusion SPECT study].
MedLine Citation:
PMID:  21944188     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To determine the clinical utility of the gated myocardial perfusion SPECT to detect silent ischemia in asymptomatic diabetic patients without previous coronary events and to evaluate the prognosis of this population.
MATERIAL AND METHODS: A retrospective study of 56 asymptomatic diabetics referred for a gated myocardial perfusion SPECT for diagnosis of ischemic disease was performed. The criteria for ischemia were: mild SDS<4, moderate SDS 4-8, severe SDS>8. A multivariable statistical analysis was carried out to identify possible predictive variables of an abnormal SPECT. The cardiovascular events were recorded up to December-2010.
RESULTS: A high proportion of the 56 patients had an abnormal perfusion study (46.4%), there being moderate-severe ischemia in 10.7%, necrosis with ischemia in 5.4% and necrosis in 7.1%. We found no statistical differences in the type of stress used (treadmill or dipyridamole). The patients had a high combination of cardiovascular risk factors. In the multivariate analysis, diabetic nephropathy was the only factor related to an abnormal SPECT (p=0.043). The events recorded in the follow-up were: 2 early revascularizations, 5 cardiology admissions, 10 non-cardiac related deaths. The existence of ischemia in the SPECT was significantly related to the appearance of cardiovascular events (p<0.05).
CONCLUSION: A gated myocardial perfusion SPECT in asymptomatic diabetics with high combination of cardiovascular risk factors detects silent ischemia in a significant proportion and this seems to be related to future coronary events. Diabetic nephropathy implies a greater likelihood of abnormal studies. However, the screening criteria in this population still need to be established for better performance and lower cost.
Authors:
R Ruano Pérez; F Gómez-Caminero López; M Diego Domínguez; A Martín De Arriba; C Martín Luengo; J R García-Talavera Fernández
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Publication Detail:
Type:  English Abstract; Journal Article     Date:  2011-09-22
Journal Detail:
Title:  Revista española de medicina nuclear e imagen molecular     Volume:  31     ISSN:  2253-8070     ISO Abbreviation:  Rev Esp Med Nucl Imagen Mol     Publication Date:    2012 Mar-Apr
Date Detail:
Created Date:  2012-03-26     Completed Date:  2012-08-09     Revised Date:  2012-10-09    
Medline Journal Info:
Nlm Unique ID:  101585329     Medline TA:  Rev Esp Med Nucl Imagen Mol     Country:  Spain    
Other Details:
Languages:  spa     Pagination:  83-8     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier España, S.L. y SEMNIM. All rights reserved.
Affiliation:
Servicio de Medicina Nuclear, Hospital Universitario de Salamanca, España. richardrua@hotmail.com
Vernacular Title:
Incidencia y valor pronóstico de la existencia de cardiopatía isquémica en pacientes diabéticos asintomáticos de alto riesgo cardiovascular sometidos a un estudio gated-SPECT de perfusión miocárdica.
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MeSH Terms
Descriptor/Qualifier:
Aged
Asymptomatic Diseases
Comorbidity
Diabetes Complications / epidemiology*,  mortality,  radionuclide imaging
Dipyridamole / diagnostic use
Exercise Test
Female
Humans
Hypercholesterolemia / epidemiology
Incidence
Male
Middle Aged
Myocardial Ischemia / epidemiology*,  radionuclide imaging
Myocardial Perfusion Imaging*
Myocardial Revascularization / utilization
Necrosis
Obesity / epidemiology
Organophosphorus Compounds / diagnostic use
Organotechnetium Compounds / diagnostic use
Patient Admission / statistics & numerical data
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk
Smoking / epidemiology
Stroke Volume
Tomography, Emission-Computed, Single-Photon*
Chemical
Reg. No./Substance:
0/Organophosphorus Compounds; 0/Organotechnetium Compounds; 0/technetium Tc 99m 1,2-bis(bis(2-ethoxyethyl)phosphino)ethane; 58-32-2/Dipyridamole

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