Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

Oki, Gláucia Celeste Rossatto; Pavin, Elizabeth João; Coelho, Otávio Rizzi; Parisi, Maria Cândida Ribeiro; Almeida, Ronaldo de; Etchebehere, Elba; Camargo, Edwaldo E.; Ramos, Celso Darío

doi:10.1590/s0100-39842013000100007

Cited by 5 publications

(6 citation statements)

References 32 publications

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“…Many studies have been conducted to evaluate the prevalence of silent myocardial ischemia in asymptomatic diabetic patients, reporting a prevalence of 9% to 57% (14). Silent ischemia is characterized by confirmed myocardial ischemia objectively without symptoms of angina or angina equivalents (15).…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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

View full text Add to dashboard Cite

show abstract

“…Many studies have been conducted to evaluate the prevalence of silent myocardial ischemia in asymptomatic diabetic patients, reporting a prevalence of 9% to 57% [14]. Silent ischemia is characterized by con rmed myocardial ischemia objectively without symptoms of angina or angina equivalents [15].…”

Section: Discussionmentioning

confidence: 99%

Assessing the prevalence and predicting factors of an abnormal gated myocardial perfusion SPECT in asymptomatic patients with type 2 diabetes

Hosseinzadeh

Ghodsirad

Alirezaie

et al. 2021

Int J Cardiovasc Imaging

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IntroductionConsidering the signi cant 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 MethodsThis 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 rst 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 de ned as CAD. ResultsThere 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 signi cantly associated with male gender, smoking, requiring insulin therapy and EF (P-value = 0.019, 0.046, 0.05, 0.033, respectively).A signi cant 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. ConclusionWe 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 bene t from MPI for early detection of silent ischemia.

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“…Los pacientes con diabetes presentan una mayor carga de factores de riesgo cardiovasculares, entre los que se incluyen significativamente hipertensión arterial, dislipemia y obesidad 6,7 . Estos múltiples factores junto con la hiperglucemia, implican un aumento de entre 2 a 4 veces del riesgo de cardiopatía coronaria y de mortalidad de origen cardiológico, en comparación con controles no diabéticos de edad y sexo similares 8 , transformando a la enfermedad arterial coronaria en la principal causa de mortalidad en estos pacientes 9 .…”

Section: Evaluación De La Calidad Nutricional De Galletitas Dulces Deunclassified

Evaluación de la calidad nutricional de galletitas dulces de bajo valor glucídico del mercado de la ciudad de Rosario, Argentina

Llopart

Pérez

Borda-Bossana

et al. 2014

Rev Esp Nutr Hum Diet

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Introducción: Las galletitas constituyen un grupo de productos farináceos muy diverso. Su consumo es tradicional y las variedades dulces envasadas se integran en la canasta básica de alimentos. Existen galletitas funcionales, que permiten su consumo a las personas con necesidades dietéticas especiales, como en el caso de diabéticos. El objetivo principal del estudio fue evaluar, a través del rotulado nutricional, la cantidad de grasas totales, ácidos grasos saturados y sodio presentes en las galletitas dulces de bajo valor glucídico, disponibles en las dietéticas de la ciudad de Rosario. Material y Métodos: Se categorizaron las galletitas como Adecuadas, Medianamente Adecuadas o No Adecuadas según la interpretación de los nutrientes críticos analizados basada en la metodología del "Sistema Semáforo" (Norma de Rotulado de la Agencia Nacional de Alimentos de Reino Unido). Resultados: Todas ellas se clasificaron dentro de la categoría de mediano contenido de grasas totales. Al evaluar el contenido de ácidos grasos saturados, el 71% se correspondió con la categoría mediano contenido y el 29% se clasificó dentro de la categoría de bajo contenido. El 57% presentaron un mediano contenido de sodio, el 14% se correspondió con la categoría de alto contenido y el 29% bajo contenido. Conclusiones: El 86% de las galletitas dulces de bajo valor glucídico analizadas en esta muestra se clasificaron como Medianamente Adecuadas, mientras que el resto de las mismas se clasificaron como No Adecuadas (14%). Ninguna de ellas cumplió con los requisitos nutricionales para poder ser categorizada como Adecuada.

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Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients

Cited by 5 publications

References 32 publications

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

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

Assessing the prevalence and predicting factors of an abnormal gated myocardial perfusion SPECT in asymptomatic patients with type 2 diabetes

Evaluación de la calidad nutricional de galletitas dulces de bajo valor glucídico del mercado de la ciudad de Rosario, Argentina

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