Predictive value of myocardial tomoscintigraphy in asymptomatic diabetic patients after percutaneous coronary intervention.
OBJECTIVE
This study was designed to assess the prognostic value of myocardial tomoscintigraphy perfusion imaging after percutaneous coronary intervention (PCI) in asymptomatic diabetic patients.


METHODS
One hundred and fourteen diabetic patients were followed up during 27+/-16 (mean+/-SD) months after the myocardial tomoscintigraphy. PCI-related events were studied after myocardial tomoscintigraphy stress testing and included major cardiac events (MACE) (cardiovascular death, myocardial infarction) and revascularization (bypass surgery or new PCI). Stress myocardial tomoscintigraphy imaging was performed 5+/-5 months after PCI and ischemia was considered as present if at least 2 contiguous segments were showing reversible defects.


RESULTS
Persistent silent ischemia was found in 49/114 (43%) patients. No difference was observed between the two groups for MACE: four among the 65 (6%) non ischemic patients versus 2 among the 49 (4%) ischemic patients (NS). In contrast, 15 (31%) among the ischemic patients and 4 (6%) among the non ischemic patients underwent iterative revascularization (p<0.01). The relative risk of revascularization for patients with significant ischemia was 5.5 versus non ischemic patients (p<0.001).


CONCLUSIONS
After PCI, in asymptomatic diabetic patients followed by myocardial tomoscintigraphy a high frequency of persistent silent ischemia was found and associated with a high risk for repeat interventional procedure, although no increase in major cardiac events was observed.
L'Huillier
Isabelle
I
Cardiology Deparatment, Centre Hospitalier Universitaire, 2 Boulevard Maréchal de Lattre de Tassigny, 21034 Dijon Cedex, France.
Cottin
Yves
Y
Touzery
Claude
C
Zeller
Marianne
M
Beel
Jean-Claude
JC
Fraison
Michel
M
Verges
Bruno
B
Louis
Pierre
P
Brunotte
François
F
Wolf
Jean Eric
JE
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D048909:Diabetes Complications; D018572:Disease-Free Survival; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D012307:Risk Factors; D015607:Stents; D015996:Survival Rate; D015899:Tomography, Emission-Computed, Single-Photon