Stress myocardial scintigraphy and dobutamine echocardiography in the detection of coronary disease in asymptomatic patients with type 2 diabetes

The Common −866G>A Variant in the Promoter of UCP2 Is Associated With Decreased Risk of Coronary Artery Disease in Type 2 Diabetic Men

“…CAD was considered absent in patients with normal stress test or with no significant coronary stenosis at angiography. Detailed procedures of stress tests and angiography have been previously reported (20). Overall, 174 patients with CAD (35% with a previous history of myocardial infarction or CABG and 65% diagnosed by coronary angiography) and 161 patients without CAD were included in the present study.…”

Myocardial perfusion scintigraphy in asymptomatic diabetic patients: a critical review

“…There are also several studies reporting only on positive predictive values of 44-100% from patients submitted to left heart catheterization because of an abnormal myocardial perfusion SPECT [30,53,[55][56][57][58][59]61,[64][65][66]70,71,78,79]. In general, the sensitivity and specificity values of MPI in asymptomatic diabetic subjects are not as good as those found in other series with mixed asymptomatic and symptomatic diabetic populations (80-86% and 56-87%, respectively) [24,80].…”

“…Therefore, it appears that this modality cannot effectively identify lower risk diabetic patients. It should be added that echocardiographic examinations may often be of suboptimal quality in diabetic patients, many of whom are overweight, this technique suffers from observer agreement and reproducibility and the experience has not been always satisfactory [70,93].…”

Maladie coronaire chez les patients diabétiques

“…Le choix initial est guidé par l'atteinte viscérale : bêta-bloquants ou inhibiteurs de l'enzyme de conversion (IEC) en cas d'antécédent d'infarctus, IEC ou antagonistes des récep-teurs de l'angiotensine-II (ARA-II) en cas de néphropathie, diurétiques, bêta-bloquants, IEC (ou ARA-II si intolérance), anti-aldostérone si insuffisance cardiaque, bêta-bloquants ou inhibiteurs calciques de longue durée d'action en cas d'atteinte coronaire [4] L'échocardiographie ou la scintigraphie myocardique de stress ne sont indiquées que lorsque l'épreuve d'effort est faiblement positive, litigieuse (sous maximale), ou ininterprétable [WolffParkinson-White (WPW), bloc de branche gauche (BBG), pacemaker]. Les valeurs prédictives positives de ces 2 techniques sont comparables pour le diagnostic de sténose coronaire, de même que leurs valeurs prédictives négatives dans la survenue d'événement cardiovasculaire [8,9]. La coronarographie conventionnelle est indiquée chez les patients avec épreuve d'effort très positive, territoire ischémique > 10 % à l'imagerie non invasive, ou anomalies ischémiques de l'ECG de repos (ondes Q de nécrose, ischémie sous épicardique sans hypertrophie ventriculaire gauche (HVG) [7].…”