AI Summary & Key Takeaways
AI InsightPatients with ischemia were significantly more likely to have ACCE during follow-up as compared to those with normal MPI scans (event rates: 21.4% vs. 3.1%, OR: 8.455 95% CI: 1.264-56.562, p=0.038).Conclusion: Myocardial ischemia as detected by adenosine stress SPECT/CT in a population of asymptomatic patients with diabetes mellitus or pre-diabetes appeared to predict the occurrence of ACCE at follow-up.
📌 3 Key Takeaways
Abstract
Objective: The aim of this study was to disclose the prevalence of myocardial ischemia, as detected by adenosine stress myocardial perfusion imaging (MPI) with hybrid single-photon emission computed tomography/computed tomography (SPECT/CT), in asymptomatic diabetic and pre-diabetic patients and to find out whether ischemia predicted the occurrence of adverse cardiac/cerebrovascular events (ACCE) at follow-up. Methods: Forty-three diabetic and thirty-five pre-diabetic asymptomatic patients without any history of coronary artery disease, underwent MPI and were followed-up for a 12.8±2.2 months for the occurrence of ACCE. Baseline variables that would predict the presence of ischemia and the value of ischemia on MPI for predicting the occurrence of ACCE at followup were evaluated by logistic regression analysis. Results: Ischemia was detected in ten (23.3%) of the diabetic and in four (11.4%) of the pre-diabetic patients. The presence of diabetes was the only independent predictor of myocardial ischemia [odds ratio (OR): 12.31, 95% confidence interval (CI): 1.83-82.66; p<0.01]. During 12.8±2.2 months of follow-up, ACCE was observed in five out of 78 (6.4%) patients. Patients with ischemia were significantly more likely to have ACCE during follow-up as compared to those with normal MPI scans (event rates: 21.4% vs. 3.1%, OR: 8.455 95% CI: 1.264-56.562, p=0.038).Conclusion: Myocardial ischemia as detected by adenosine stress SPECT/CT in a population of asymptomatic patients with diabetes mellitus or pre-diabetes appeared to predict the occurrence of ACCE at follow-up.
Özet
Amaç: Bu çalışmanın amacı asemptomatik diyabetik ve pre-diyabetik hastalarda stres miyokardiyal perfüzyon tek foton emisyon bilgisayarlı tomografi/bilgisayarlı tomografi miyokard perfüzyon sintigrafisi (MPS) ile miyokardiyal iskemi prevalansını belirlemek ve iskemi bulgularının takipte istenmeyen kardiyak ve serebrovasküler olayları öngörüp görmediğini saptamaktır.Yöntem: Daha önce bilinen koroner arter hastalığı olmayan 43 diyabetik ve 35 pre-diyabetik asemptomatik hastaya MPS yapılarak, hastalar istenmeyen kardiyak/serebrovasküler olaylar açısından ortalama 12,8±2,2 ay takip edildi. İskemiyi öngören bazal değişkenler ve MPS'nin takipte istenmeyen kardiyovasküler olayları öngörmedeki değeri lojistik regresyon modeli ile değerlendirildi.Bulgular: Diyabetik hastaların onunda (%23,3) ve pre-diyabetik hastaların dördünde (%11,4) MPS ile iskemi saptandı. Miyokardiyal iskemi açısından tek bağımsız risk faktörü diabetes mellitus varlığı idi (odds ratio (OR): 12,31, %95 güven aralığı (GA): 1,83-82,66; p<0,01). Ortalama 12,8±2,2 aylık takip süresi boyunca yetmiş sekiz hastanın beşinde (%6,4) istenmeyen kardiyovasküler olay gelişti. Sintigrafide iskemi bulgusu olanların takibinde kardiyovasküler olay gelişme riski, normal MPS bulguları olanlara göre belirgin olarak yüksekti (olay oranı: %21,4 ile %3,1, OR: 8,455 %95 GA: 1,264-56,562, p=0,038).Sonuç: Adenozin stres SPECT/CT ile saptanan iskeminin asemptomatik diyabetik ve pre-diyabetik hastalarda takipte gelişecek olan kardiyovasküler olayları öngördüğü söylenebilir.