Document Detail


Surveillance study for creating the national clinical database relating to ECG-gated myocardial perfusion SPECT of asymptomatic ischemic heart disease in patients with type-2 diabetes mellitus: J-ACCESS 2 study design.
MedLine Citation:
PMID:  18250983     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Diabetes mellitus is an independent risk factor for acute myocardial infarction. Thus, a surveillance study was conducted as part of studies to create a national database related to electrocardiogram (ECG)-gated myocardial perfusion single-photon emission computed tomography (SPECT) of ischemic heart disease. METHODS: Single-photon emission computed tomography was conducted in patients with type 2 diabetes mellitus and their prognoses will be followed for 3 years, stratified by patients' clinical background and SPECT findings. RESULTS: A total of 513 patients from 50 institutions were enrolled in this study, 297 of whom were men (age 66.2 +/- 0.4 years, mean +/- SEM) and 261 women (age 67.8 +/- 0.5 years). They have a history of retinopathy (25.3%), neuropathy (19.9%), cerebrovascular disorder, chronic obstructive pulmonary disease, and photocoagulation. Major risk factors for present disease were hypertension (82.3%) and hyperlipidemia (79.7%). In 244 patients (129 men and 115 women), body mass index (BMI) was 25 or more. Fifty-two of them (10.1%) underwent coronary angiography; of these, 26 (50.0%) had no coronary artery lesions with 75% or more stenosis, and only 1 (1.9%) had a left main trunk with 50% or more stenosis. An overwhelming majority of patients (94.3%) underwent SPECT imaging by a 1-day stress-followed-by-rest procedure. Stress procedure was exercise in most (70.8%) patients, followed by dipyridamole infusion in 14.6%, adenosine infusion in 6.6%, and adenosine triphosphate infusion in 5.7%. Endpoint of stress examination was most often fatigue in lower limbs (40.7%), followed by completion of pharmacological stress protocol (28.7%), and achievement of target heart rate (26.3%). The largest number of patients (198, 38.6%) received (99m)Tc-tetrofosmin at an initial dosage of 200-300 MBq (mean 331 +/- 3 MBq) followed by a second dosage of 700-800 MBq (mean 748 +/- 8 MBq). Among them, 491 (95.7%) received some kind of therapeutic drug: hypoglycemic drugs were used by the largest number (83.2%), followed by hypotensive (66.7%), hypolipidemic (40.7%), and antiplatelet drugs (27.7%), vasodilators (5.5%), and antioxidants and others (2.3%). CONCLUSIONS: This study was designed to clarify the correlation between coronary artery disease and diabetes mellitus as its risk factor based on the clinical and imaging findings. Patient enrollment was closed on September 30, 2005, and follow-up is now under way.
Authors:
Hideo Kusuoka; Yoshimitsu Yamasaki; Tohru Izumi; Atsunori Kashiwagi; Ryuzo Kawamori; Kazuaki Shimamoto; Nobuhiro Yamada; Tsunehiko Nishimura
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of nuclear medicine     Volume:  22     ISSN:  0914-7187     ISO Abbreviation:  Ann Nucl Med     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2008-02-05     Completed Date:  2008-04-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8913398     Medline TA:  Ann Nucl Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  13-21     Citation Subset:  IM    
Affiliation:
National Hospital Organization, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka, 540-0006, Japan. kusuoka@onh.go.jp
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MeSH Terms
Descriptor/Qualifier:
Comorbidity
Diabetes Mellitus, Type 2 / diagnosis*,  epidemiology*
Electrocardiography / statistics & numerical data
Female
Gated Blood-Pool Imaging / statistics & numerical data*
Humans
Incidence
Japan / epidemiology
Male
Middle Aged
Myocardial Ischemia / diagnosis*,  epidemiology*
Population Surveillance / methods*
Registries*
Risk Assessment / methods*
Risk Factors
Tomography, Emission-Computed, Single-Photon / statistics & numerical data

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


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