Journal List > Korean Diabetes J > v.33(3) > 1002293

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Kim, Jung, Koh, Kim, Park, Lee, Park, Ryu, and Lee: Frequency of Silent Myocardial Ischemia Detected by Thallium-201 SPECT in Patients with Type 2 Diabetes
Original Article
Korean Diabetes Journal

Korean Diabetes Journal 2009; 33(3): 225-231.

Published online: 30 June 2009

DOI: https://doi.org/10.4093/kdj.2009.33.3.225

Frequency of Silent Myocardial Ischemia Detected by Thallium-201 SPECT in Patients with Type 2 Diabetes

Dong Woo Kim1, Eun Hee Jung1, Eun Hee Koh1, Min Seon Kim1, Joong Yeol Park1, Seung Whan Lee2, Seong Wook Park2, Jin Sook Ryu3, Ki Up Lee1

1Department of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

2Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

3Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Corresponding author (kulee@amc.seoul.kr)

Received 4 March 2009       Accepted 27 May 2009

Copyright © 2009 Korean Diabetes Association

Abstract

Background

Silent myocardial ischemia (SMI) is more common in diabetic patients than among the general population. It is not yet established whether a routine screening test for SMI is necessary, and which screening test would be most useful. The purpose of this study was to estimate the prevalence of SMI detected by Thallium-201 perfusion single photon emission computed tomography (SPECT) in type 2 diabetic patients.

Methods

A total of 173 asymptomatic type 2 diabetic patients were included in the study. Thallium-201 perfusion SPECT was performed to screen for SMI.

Results

Among the 173 patients, abnormal perfusion patterns were found in 11 patients. Coronary angiography was carried out for these patients, and significant coronary artery stenosis was found in ten of them (positive predictive value; 90.9%). There was a significant association between SMI and overt albuminuria (OR = 7.33, 95% CI, 1.825-29.437).

Conclusion

Thallium-201 perfusion SPECT is not sensitive enough to identify SMI, but is accurate in detecting decreased myocardial perfusion. This may be a useful screening tool for detecting SMI in type 2 diabetic patients with impaired renal function.

Keywords: Albuminuria, Myocardial ischemia, SPECT, Type 2 diabetes mellitus

Figures and Tables

Fig. 1
Proportions of stenosis of coronary artery after coronary angiography in patients performed SPECT. CAG, coronary angiography; SPECT, single photon emission computed tomography.
kdj-33-225-g001
Table 1
Clinical characteristics of the study subjects
kdj-33-225-i001

Data are expressed as median(IQR). *P < 0.05 was considered significant. Continuous variables were analyzed by Mann-Whitney U test and categorical variables by χ2 test. BMI, body mass index; BP, blood pressure; CAD, coronary artery disease; CAS, coronary artery stenosis; HDL, high density lipoprotein; LDL, low density lipoprotein.

Table 2
Multivariate logistic regression analysis with presence of CAD as a dependent variable
kdj-33-225-i002

BMI, body mass index; CAD, coronary artery disease; LDL, low density lipoprotein.

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