Document Detail


Preoperative risk evaluation in diabetic patients without angina.
MedLine Citation:
PMID:  18456365     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The aim of the current study was to clarify whether stress myocardial perfusion single-photon emission computed tomography (SPECT) stratifies perioperative cardiac risk in noncardiac surgery of diabetic patients without chest pain. METHODS: This study enrolled consecutive 284 patients with diabetes mellitus (DM) without chest pain who underwent noncardiac surgery after dipyridamole stress SPECT. Myocardial perfusion and cardiac function were simultaneously evaluated in the SPECT examination. We sought clinical and imaging variables predictive of perioperative cardiac events, and estimated the prognostic value of SPECT. RESULTS: No clinical risk factors were proved to be significant predictors of perioperative cardiac events except the duration of diabetes. In contrast, myocardial perfusion imaging itself and the combination of information on perfusion and cardiac function provided significant risk stratification. The event rate in patients with normal perfusion was low regardless of surgical procedures, while that in patients with abnormal perfusion increased depending on the operation risk. CONCLUSIONS: Normal myocardial SPECT findings ensure the low likelihood of perioperative cardiac events in DM patients without chest pain. Perfusion and/or functional abnormalities are associated with the adverse outcome especially in high-risk operation.
Authors:
Jingming Bai; Jun Hashimoto; Tadaki Nakahara; Naoto Kitamura; Takayuki Suzuki; Atsushi Kubo
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-05-23
Journal Detail:
Title:  Diabetes research and clinical practice     Volume:  81     ISSN:  1872-8227     ISO Abbreviation:  Diabetes Res. Clin. Pract.     Publication Date:  2008 Aug 
Date Detail:
Created Date:  2008-07-28     Completed Date:  2008-08-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508335     Medline TA:  Diabetes Res Clin Pract     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  150-4     Citation Subset:  IM    
Affiliation:
21st Century Center of Excellence Program, School of Medicine, Keio University, Tokyo, Japan. bjingming@mail.goo.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Diabetes Mellitus / physiopathology*,  radionuclide imaging*
Exercise Test
Heart / radionuclide imaging*
Humans
Postoperative Complications / epidemiology*,  prevention & control
Preoperative Care / methods*
Prognosis
Retrospective Studies
Risk
Risk Assessment
Surgical Procedures, Operative*
Tomography, Emission-Computed, Single-Photon

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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