Introduction/Objective. Myocardial perfusion imaging (MPI) is clinically
useful for the evaluation of coronary artery disease (CAD) in patients with
diabetes mellitus (DM). However, the prevalence of ischemia and its ability
to predict future cardiac events is less clear. The aim was to determine the
incidence of cardiac events in diabetic patients and relationship between
them and MPI findings. Methods. Two cohorts of patients, 98 diabetics and
100 non-diabetics, with medium- to high-risk of CAD without previous
coronary revascularization were studied prospectively. All of them were
outpatients underwent 99mTc-sestamibi MPI with dipyridamole. The data about
cardiac events were collected during follow-up period of two years.
Results. Cardiac events occurred in 17.3% diabetics and in 8% non-diabetics
(p = 0.048). Diabetics had shorter estimated event-free time 24.7 months
(95% CI 23.2-26.2) versus non-diabetics 28.5 months (95% CI 27.4-29.5) (p =
0.046). The independent predictors of cardiac events were male sex (p =
0.010), previous myocardial infarction (p < 0.001), presence of the symptoms
of angina (p = 0.014) and all variables derived from MPI findings. After
adjustment for variables derived from MPI findings, the significant
predictors in diabetics were size of stress perfusion defect (p = 0.022),
summed stress score (p = 0.011) and summed difference score (p = 0.044).
Conclusion. In diabetic patients, the cumulative rate of cardiac events was
higher and the event-free survival was worse. MPI could help in prediction
of cardiac events in diabetics and the most important predictors were size
of stress perfusion defect, summed stress score and summed difference score.