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   coronary risk equivalence of diabetes assessed by spect-mpi  
   
نویسنده morales donna chelle v. ,bhavnani sanjeev p. ,ahlberg alan w. ,pullatt raja c. ,katten deborah m. ,polk donna m. ,heller gary v.
منبع journal of nuclear cardiology - 2019 - دوره : 26 - شماره : 4 - صفحه:1093 -1102
چکیده    Several publications and guidelines designate diabetes mellitus (dm) as a coronary artery disease (cad) risk equivalent. the aim of this investigation was to examine dm cardiac risk equivalence from the perspective of stress spect myocardial perfusion imaging (mpi). we examined cardiovascular outcomes (cardiac death or nonfatal mi) of 17,499 patients referred for stress spect-mpi. patients were stratified into four categories: non-dm without cad, non-dm with cad, dm without cad, and dm with cad, and normal or abnormal perfusion. cardiac events occurred in 872 (5%), with event-free survival best among non-dm without cad, worst in dm with cad, and intermediate in dm without cad, and non-dm with cad. after multivariate adjustment, risk remained comparable between dm without cad and non-dm with cad [ahr 1.0 (95% ci 0.84–1.28), p =0.74]. annualized event rates for normal subjects were 1.4% and 1.6% for non-dm with cad and dm without cad, respectively (p = 0.48) and 3.5% (p = 0.95) for both abnormal groups. after multivariate adjustment, outcomes were comparable within normal [ahr 1.4 (95% ci 0.98–1.96) p = 0.06] and abnormal [ahr 1.1 (95% ci 0.83–1.50) p = 0.49] mpi. diabetic patients without cad have comparable risk of cardiovascular events as non-diabetic patients with cad after stratification by mpi results. these findings support diabetes as a cad equivalent and suggest that mpi provides additional prognostic information in such patients.
کلیدواژه diabetes mellitus ,coronary artery disease equivalent ,myocardial perfusion imaging
آدرس southside hospital, usa, scripps translational science institute, usa, hartford hospital, henry low heart center, nuclear cardiology laboratory, usa, union county cardiology associates, usa, hartford hospital, henry low heart center, nuclear cardiology laboratory, usa, brigham and women’s hospital, division of cardiology, usa, morristown medical center, gagnon cardiovascular institute, usa
 
     
   
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