Key result
A coronary calcium score >100 and functional capacity <5 METS, but not an abnormal MPI, were associated with cardiac events at 3-year follow-up in asymptomatic type 2 diabetic patients (P=0.01).
Why the study?
Do baseline myocardial perfusion imaging variables, coronary calcium score, and functional capacity predict adverse events at 3 years in asymptomatic patients with type 2 diabetes?
Cohort (n=41)
Do baseline myocardial perfusion imaging variables, coronary calcium score, and functional capacity predict adverse events at 3 years in asymptomatic patients with type 2 diabetes?
In asymptomatic patients with type 2 diabetes, a coronary calcium score >100 and low functional capacity (<5 METS) are better predictors of medium-term adverse events than myocardial perfusion imaging.
Coronary calcium scoring and functional capacity may aid risk stratification over MPI in asymptomatic type 2 diabetes; leaves open optimal screening pending prospective validation.
OBJECTIVE: The aim of the study was to identify the possible association among myocardial perfusion imaging (MPI) variables, coronary calcium score (CCS), and adverse events at medium term in type 2 asymptomatic diabetes mellitus patients. MATERIALS AND METHODS: Patients who participated in a first study that included a stress-rest MPI and a CCS assessment were asked to take part in this study. The present study protocol required a control single-photon emission computerized tomography after 3 years. Forty-one patients gave their informed consent. RESULTS: Of the 41 patients, 13 (32%) showed perfusion defects at the initial MPI. Of them, at 3 years, five continued showing perfusion defects, whereas another two had new defects (incidence of ischemia of 17%). Thus, 61% of the initial positive MPIs were normal at 3 years (P=0.04). In these cases the therapy was modified between the two studies. Left ventricular ejection fraction at stress showed a slight increase at 3 years (P=NS). Ventricular volumes significantly decreased at 3 years (P<0.01). Three patients (7.3%) developed an event during the follow-up (FU): two noncardiac deaths and one non-ST elevation myocardial infarction. The only variables that showed a possible association with the occurrence of events at FU were a CCS higher than 100 and less than 5 metabolic equivalents (METS) reached during the stress test (P=0.01). CONCLUSION: A CCS higher than 100 and a low functional capacity (<5 METS), but not an abnormal MPI, can be associated with cardiac events at 3-year FU in asymptomatic type 2 diabetic patients.
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Peix et al. (2014) conducted a cohort in type 2 asymptomatic diabetes mellitus (n=41). Coronary calcium score >100 and functional capacity <5 METS was evaluated on Adverse events (cardiac events) (p=0.01). A coronary calcium score >100 and functional capacity <5 METS, but not an abnormal MPI, were associated with cardiac events at 3-year follow-up in asymptomatic type 2 diabetic patients (P=0.01).
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