Evaluation of Silent Myocardial Ischemia with Single-Photon Emission Computed Tomography/Computed Tomography in Asymptomatic Subjects with Diabetes and Pre-Diabetes

• Published in: Molecular imaging and radionuclide therapy Vol. 25; no. 2; pp. 70 - 78
• Main Authors: Özdemir, Elif, Burçak Polat, Şefika, Yıldırım, Nilüfer, Türkölmez, Şeyda, Ersoy, Reyhan, Durmaz, Tahir, Keleş, Telat, Bozkurt, Engin, Çakır, Bekir
• Format: Journal Article
• Language: English
• Published: Turkey Galenos Publishing 01.06.2016
• Subjects: Original
• ISSN: 2146-1414; 2147-1959
• DOI: 10.4274/mirt.24633

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. 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 (8-19) 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 follow-up were evaluated by logistic regression analysis. 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 (8-19) 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). 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.