Prognostic value of myocardial perfusion scintigraphy in type 2 diabetic patients with mild, stable angina pectoris
| Autor: | Jan G.P. Tijssen, Berthe L. F. van Eck-Smit, Ineke M. Radder, Lea M. Dijksman, H. J. Verberne, Jan J. Piek, Jacobijne J. Wiersma, Wik L. ten Holt, Mieke D. Trip |
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| Přispěvatelé: | Cardiology, Amsterdam Cardiovascular Sciences, Nuclear Medicine, Faculteit der Geneeskunde |
| Jazyk: | angličtina |
| Rok vydání: | 2009 |
| Předmět: |
Male
Risk medicine.medical_specialty Myocardial ischemia Myocardial Infarction Stable angina angina pectoris Internal medicine Diabetes mellitus Myocardial perfusion scintigraphy medicine Humans Insulin Radiology Nuclear Medicine and imaging In patient Aged Proportional Hazards Models business.industry Myocardial Perfusion Imaging nutritional and metabolic diseases Type 2 Diabetes Mellitus Diabetes mellitus type 2 Middle Aged medicine.disease myocardial ischemia Radiology Nuclear Medicine and imaging SPECT Multivariate Analysis Cardiology Myocardial infarction complications Female Original Article prognosis Cardiology and Cardiovascular Medicine business Perfusion |
| Zdroj: | Journal of nuclear cardiology, 16(4), 524-532. Springer New York Journal of Nuclear Cardiology |
| ISSN: | 1071-3581 |
| Popis: | Aim: To determine the prognostic value of reversible myocardial perfusion defects on myocardial perfusion scintigraphy (MPS) in patients with type 2 diabetes mellitus and mild anginal complaints.Methods and results: In the MERIDIAN trial, patients with diabetes mellitus type 2, stable, mild anginal symptoms (Canadian Cardiovascular Society classification (CCS) I-II/IV) and reversible perfusion defects were randomized to either continued pharmacological treatment or early invasive treatment. In this sub analysis, the severity of the myocardial perfusion defect was related to the occurrence of cardiac death and non-fatal myocardial infarction, in 319 patients (63% male, 65 ± 9 years). During follow-up (2.2 ± 0.6 years), 14 patients had a cardiac event: 3 in 171 patients without myocardial ischemia and 11 in 148 patients with myocardial ischemia. Annual event rates rose from 0.8% to 5.8% with increasing severity of myocardial ischemia. Multivariable analysis identified the presence of severe myocardial ischemia (hazard ratio (HR) 5.45, 95%CI 1.89-15.71) and insulin use (HR 4.00, 95%CI 1.25-12.75) as independent predictors of cardiac events.Conclusions: Type 2 diabetics with mild anginal symptoms with no or moderate myocardial ischemia have a low annual cardiac event rate. In patients with severe myocardial ischemia event rate increased 3-6 fold. |
| Databáze: | OpenAIRE |
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