Microalbuminuria predicts silent myocardial ischaemia in type 2 diabetes patients

Giovacchini, Giampiero; Cappagli, M; Carro, Stefano; Borrini, Sandro; Montepagani, A.; Leoncini, Rossella; Mazzotta, Gianfranco; Sambuceti, Gianmario; Mariani, Giuliano; Volterrani, Duccio; Zellweger, Michael J.; Ciarmiello, Andrea

doi:10.1007/s00259-012-2323-5

Cited by 15 publications

(17 citation statements)

References 57 publications

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“…The predictive role of an increased BNP-value at baseline is in line with results of a primary prevention study in which BNP was used to identify end organ damage of the heart: in asymptomatic primary prevention patients, BNP screening was able to identify silent heart disease [17]. On the other side and in contrast to several other studies [18,19], neither an increased creatinine level nor the presence of microalbuminuria were independently predictive of an abnormal MPS in the present analysis. This may be explained partly by the frequent use of ACE-/ARB-inhibitors (77%), the highly selected patient group tested and the multiple predictors analysed in the current versus older studies [15,18].…”

Section: Predictors Of An Abnormal Mps In Asymptomatic Diabetic Patientssupporting

confidence: 88%

Predictors and prognostic impact of silent coronary artery disease in asymptomatic high-risk patients with diabetes mellitus

Zellweger

Haaf

Maraun³

et al. 2017

International Journal of Cardiology

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Section: Predictors Of An Abnormal Mps In Asymptomatic Diabetic Patientssupporting

confidence: 88%

Predictors and prognostic impact of silent coronary artery disease in asymptomatic high-risk patients with diabetes mellitus

Zellweger

Haaf

Maraun³

et al. 2017

International Journal of Cardiology

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“…They recommend screening for male patients in whom the duration of DM is 10 years or even less when more than one cardiovascular risk factor is present. In a recent study by Giovacchini et al, (20) microalbuminuria was the only predictor of silent ischemia in diabetes. Gokcel et al (12) reported a positive correlation between silent ischemia and retinopathy, male sex, hypertension and low HDL-cholesterol levels in patients with DM.…”

Section: Discussionmentioning

confidence: 89%

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

Özdemir¹,

Polat²,

Yıldırım³

et al. 2016

Mirt

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Objective: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.Methods: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.Results: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).Conclusion: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.

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“…El obtener sobre 10 METS en la PE es buen predictor de ausencia de eventos coronarios en el seguimiento, independiente de otros FRCV e incluso de la presencia de isquemia. 21,22 Respecto a la asociación de IS y presencia de microalbuminuria, también la observamos (en 44%) como otros autores 20 , para quienes aquella fue el único predictor de IS en DM tipo 2. En este estudio sólo el paciente con insuficiencia cardíaca, de los con evento mayor, la presentó.…”

Section: Materials Y Métodosunclassified

Seguimiento a Cinco Años en Pacientes Diabéticos Sin Síntomas Cardíacos Estudiados Con Perfusión Miocárdica

et al. 2013

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5 años, >45 años de edad, con >2 factores de riesgo cardiovascular (FRCV) y electrocardiograma basal normal o con alteraciones inespecíficas. Todos efectuaron una prueba de esfuerzo (PE) adecuada y se estudiaron con Sestamibi-Tc99m repetido en 32 casos al 3° año. Además, se evaluó a 36 controles no diabéticos con >2 FRCV. El seguimiento fue de 64±11 meses. Resultados: En el grupo DM, 48% tenía Hba1c>7.5%; en ellos el SPECT mostró isquemia silente (IS) en 30% y la PE en 18% del total. No hubo variaciones significativas en SPECT al 3° año. Hubo una muerte no cardíaca en el 2° año; en el 4° año, se produjo una muerte por infarto agudo de miocardio, con mínima isquemia septal y otra asociada a miocardiopatía e insuficiencia cardíaca, con defecto de predominio fijo, ambos con PE negativa. En el grupo control, el 11% tuvo SPECT anormal y 8% PE positiva; hubo una muerte no cardíaca. El Odds Ratio para isquemia fue 3.42 [IC=0.99-11.85] entre DM vs controles y el Hazard Ratio para eventos cardíacos 6.75 [IC=0.40-108.2]. Conclusiones: En DM asintomáticos coronarios el riesgo de IS en SPECT fue mayor que en controles sin DM y con FRCV. Los eventos cardiacos mayores fueron más frecuentes, aunque no significativamente, en DM que en controles. Ello deberá reevaluarse conocidos los resultados del estudio multicéntrico.]]>

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Microalbuminuria predicts silent myocardial ischaemia in type 2 diabetes patients

Cited by 15 publications

References 57 publications

Predictors and prognostic impact of silent coronary artery disease in asymptomatic high-risk patients with diabetes mellitus

Predictors and prognostic impact of silent coronary artery disease in asymptomatic high-risk patients with diabetes mellitus

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

Seguimiento a Cinco Años en Pacientes Diabéticos Sin Síntomas Cardíacos Estudiados Con Perfusión Miocárdica

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