Prognostic value of myocardial perfusion scintigraphy in diabetic patients and without coronary lesion

Abstract

Objective: To determine the prognostic value of myocardial perfusion scintigraphy-gated SPECT in patients with diabetes mellitus and without obstructive coronary artery disease.

Materials and methods: This retrospective study included consecutive patients undergoing adenosine stress-rest myocardial perfusion imaging (MPI) by ^99mTc-tetrofosmin between 2009 and 2011. The patients had diabetes mellitus and coronary angiography without significant coronary lesions. In total, 37 diabetic patients (female/male: 20/17; mean age: 65.2 (range: 40-78). 29 non-diabetic patients were included wich are matched with the group of diabetic patients with positive MPI. The group of non-diabetic patients had scintigraphy with myocardial ischemia and without angiographic lesions. A 36-month clinical follow-up was performed, and major cardiac events were recorded.

Results: In 78.3% (29/37) of diabetic patients the scintigraphic study showed myocardial ischemia, while it was negative in the 21.7%. The cardiac event rate in both groups was 6%. In diabetics with a myocardial perfusion study with myocardial ischemia, there were 3 major cardiac events. In diabetic patients with negative study had no cardiac event. In the non-diabetic control group the cardiac events rate was 3.4% (1/29).

Conclusion: In diabetic patients without obstructive coronary disease, myocardial perfusion study can be predictor of cardiac events. A negative study can be an indicator of a better cardiovascular prognosis.

Keywords: Coronary lesions; Diabetes mellitus; Disfunción microvascular; Estudios isotópicos de perfusión miocárdica; Isotopic study of myocardial perfusion; Lesiones coronarias; Microvascular dysfunction.