Prognostic implications of myocardial perfusion imaging and coronary calcium score in a Macedonian cohort of asymptomatic patients with type 2 diabetes

Mitevska, Irena; Baneva, Natalija; Srbinovska, Elizabeta; Stojanovska, Lily; Apostolopoulos, Vasso; Bosevski, Marijan

doi:10.1177/1479164116680776

Cited by 10 publications

(9 citation statements)

References 23 publications

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“…The complicated lesions, such as diffuse and calcified lesion, are often presented in the coronary stenosis related with DM [3] . The relationship between complicated nonobstructive and atherosclerotic calcification lesions with DM-related silent myocardial ischemia has been reported, but its mechanism remains unsolved [4] , [5] . The diagnostic delay often causes fatal cardiovascular events, and then it is desired to develop the specific screening tool for silent myocardial ischemia.…”

Section: Introductionmentioning

confidence: 99%

Oncostatin M is a novel biomarker for coronary artery disease – A possibility as a screening tool of silent myocardial ischemia for diabetes mellitus

Ikeda

Sato

Takeda

et al. 2021

IJC Heart & Vasculature

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Objective Oncostatin M (OSM) is an inflammatory cytokine of the interleukin-6 family which plays a crucial role in the pathogenesis of atherosclerosis. Therefore, we tested our hypothesis that serum OSM levels are increased in patients with coronary artery diseases (CAD). Methods and results Serum OSM level was measured by sandwich technique immunoassay in 315 consecutive patients and who underwent coronary angiography at the International University of Health and Welfare Hospital from April 2019 to March 2021. A diagnosis of CAD was made in 169 patients. Serum OSM levels were significantly higher in patients with significant coronary stenosis compared to those without it. [123.0 ± 46.7 pg/mL (n = 169) vs. 98.3 ± 47.9 pg/mL (n = 146), p < 0.001]. A positive correlation was noted between serum OSM levels and severity and complexity of coronary stenosis. Importantly, the coronary revascularization significantly decreased the serum OSM levels. We furthermore detected a positive correlation between serum OSM levels and HbA1c levels. Finally, our data suggested that 120 pg/mL of serum OSM was the potential cutoff value for screening of silent myocardial ischemia related with diabetic mellitus (DM). Conclusion Serum OSM can be a novel biomarker for CAD and may be useful for the screening of asymptomatic CAD in patients with DM.

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Section: Introductionmentioning

confidence: 99%

Oncostatin M is a novel biomarker for coronary artery disease – A possibility as a screening tool of silent myocardial ischemia for diabetes mellitus

Ikeda

Sato

Takeda

et al. 2021

IJC Heart & Vasculature

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“…[25] Prognostic value of MPI and CCS was also established in our previous studies. [2627] There is an ongoing debate whether ischemia-based management in both symptomatic and asymptomatic patients with suspected or established stable CAD could change prognosis. Several studies such as COURAGE and BARI 2D have not shown any prognostic advantages of invasive management of patients with stable CAD.…”

Section: Discussionmentioning

confidence: 99%

Single-photon emission computed tomography myocardial ischemia detection in high-risk asymptomatic patients: correlation with coronary calcium score and high-sensitivity C-reactive protein

et al. 2019

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Background: The association between myocardial ischemia in high-risk patients with coronary calcium score (CCS) and high-sensitivity C-reactive protein (hs-CRP) is not well established. Aims: We evaluated the correlation between hs-CRP, CCS, and myocardial ischemia in asymptomatic high-risk patients without known coronary artery disease (CAD). Materials and Methods: We prospectively assessed 68 asymptomatic high-risk outpatients without known CAD. One-day rest-stress Tc-99m single-photon emission computed tomography (SPECT) myocardial perfusion imaging and multislice computed tomography were performed. Multivariate regression analysis was performed for the assessment of predictors of myocardial ischemia. Standard risk factors and hs-CRP values were analyzed. Results: CCS >0 Agatston score was observed in 26 patients (46.4%). Seven patients had CCS between 10 and 99 AU, 8 patients between 100 and 400 AU, and 11 patients had CCS >400 AU. Mild ischemia was noted in 11 patients, moderate ischemia in 10 patients, and severe ischemia in 6 patients. Hs-CRP was >1 mg/L in 39 patients, of whom 8 patients had CCS >0, 13 patients had normal SPECT results, 6 patients had mild ischemia, and 12 patients had moderate and severe ischemia. Multivariate regression analysis showed independent predictors for increased CCS: low-density lipoprotein cholesterol (odds ratio [OR]: 2.891; P = 0.001); age >70 years (OR: 2.568; P = 0.001); and smoking (OR: 1.931; P = 0.001). We found hs-CRP to be an independent predictor of myocardial ischemia (OR: 4.145; 95% confidence interval: 1.398–7.471, P = 0.001). Conclusion: hs-CRP was an independent predictor of myocardial ischemia. hs-CRP might improve the selection of high-risk asymptomatic patients for myocardial SPECT imaging.

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“…On the other hand, CAD as a major cause of morbidity, mortality, and financial costs in patients with T2DM, could be asymptomatic in 20-35% of diabetic patients (3). However, acute myocardial infarction (MI) and sudden cardiac death might be often the initial presentations (4,5). Developing at a younger age, higher rate of multi-vessel disease and being more prone to have complications after MI, such as congestive heart failure, are some of the features indicating the overall poorer outcome of CAD in diabetic patients (6)(7)(8).…”

Section: Introductionmentioning

confidence: 99%

“…It has been suggested that myocardial perfusion imaging (MPI) is a reliable technique for risk assessment of CAD in diabetic patients (10)(11)(12). It is still under debate whether screening myocardial ischemia is rational in asymptomatic diabetic patients compared to standard therapeutic strategies and whether it improves the risk stratification, management, and prognosis in different patient groups (4). Therefore, the aim of this study was to assess CAD risk, prevalence and Predicting Factors of an Abnormal Gated Myocardial Perfusion SPECT in Asymptomatic Patients with Type 2 Diabetes .…”

Section: Introductionmentioning

confidence: 99%

Assessing the Prevalence and Predicting Factors of an Abnormal Gated Myocardial Perfusion SPECT in Asymptomatic Patients with Type 2 Diabetes

Hosseinzadeh¹,

Ghodsirad

Alirezaei³

et al. 2021

Preprint

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Introduction: Considering the significant prevalence of silent myocardial ischemia and its related morbidity and mortality in asymptomatic type two diabetic patients, it is not well known whether early screening with MPI is cost-effective. However, predicting factors are not elucidated. Materials and Methods: This was a cross-sectional study including 63 asymptomatic patients with type 2 diabetes mellitus (T2DM), with normal ECG and ejection fraction. Patients with any history of documented valvular, congestive or ischemic heart disease, renal or hepatic failure were excluded. At first all patients were interviewed and checked for risk factors and then patients underwent a two-day rest/stress 99mTc-MIBI gated MPI SPECT. Data was assessed by QPS/QGS and 4DM software and evaluated by a nuclear medicine specialist with summed stress score (SSS) of more than 4 defined as CAD. Results: There were 42 females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years and 7.97 ± 4.86 years history of T2DM. CAD was detected in 26 (41.3%) patients and was significantly associated with male gender, smoking, requiring insulin therapy and EF (P-value = 0.019, 0.046, 0.05, 0.033, respectively). A significant association was found between the duration of diabetes, especially when >15y, and the probability of having CAD.. Multivariable logistic regression revealed that smoking; male gender and diabetes duration were the strongest independent predictors of abnormal MPI results. Conclusion: We found a high (46%) prevalence of abnormal stress MPI SPECT in patients with type 2 diabetes mellitus, despite being asymptomatic. Asymptomatic patients with a history of smoking, long duration of diabetes, being under insulin treatment and male gender might benefit from MPI for early detection of silent ischemia. Keyword: 99mTc-MIBI; Gated Myocardial Perfusion Imaging; Type 2 Diabetes Mellitus; Silent Ischemia; Asymptomatic CAD; Early Screening

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Prognostic implications of myocardial perfusion imaging and coronary calcium score in a Macedonian cohort of asymptomatic patients with type 2 diabetes

Cited by 10 publications

References 23 publications

Oncostatin M is a novel biomarker for coronary artery disease – A possibility as a screening tool of silent myocardial ischemia for diabetes mellitus

Oncostatin M is a novel biomarker for coronary artery disease – A possibility as a screening tool of silent myocardial ischemia for diabetes mellitus

Single-photon emission computed tomography myocardial ischemia detection in high-risk asymptomatic patients: correlation with coronary calcium score and high-sensitivity C-reactive protein

Assessing the Prevalence and Predicting Factors of an Abnormal Gated Myocardial Perfusion SPECT in Asymptomatic Patients with Type 2 Diabetes

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