Prevalence of myocardial ischaemia as assessed with myocardial perfusion scintigraphy in patients with diabetes mellitus type 2 and mild anginal symptoms.
OBJECTIVE
To determine the prevalence and predictors of reversible myocardial perfusion defects, indicative of myocardial ischaemia, in patients with mild, stable anginal complaints [Canadian Cardiovascular Society classification (CCS) I-II/IV] and diabetes mellitus type 2 (T2DM).


METHODS
A total of 329 patients with T2DM and stable, mild anginal symptoms (CCS I-II/IV) underwent myocardial perfusion scintigraphy. Perfusion images were assessed using a five-point (semi)-quantitative scoring system according to a 17-segment myocardial model.


RESULTS
One-hundred and fifty-six (47%) patients showed reversible myocardial perfusion defects defined as a summed difference score of >or=3. Male gender [odds ratio (OR) 2.28, 95% CI 1.4-3.71, p=0.001], previous myocardial infarction (MI) without revascularisation (OR 3.04, 95% CI 1.28-7.24, p=0.01), and the use of two or more classes of anti-anginal medication (OR 2.36, 95% CI 1.48-3.76, p<0.001) were independent predictors for the presence of reversible defects. By contrast, lipid-lowering therapy reduced the possibility of reversible perfusion defects (OR 0.56, 95% CI 0.33-0.95, p=0.03).


CONCLUSIONS
Approximately half of the patients with mild, stable angina pectoris and T2DM showed evidence of myocardial ischaemia. Male gender, previous MI and the use of anti-anginal medication were positive predictors and lipid-lowering therapy was a negative predictor for the results of the scintigraphic stress test.
Wiersma
Jacobijne J
JJ
Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. j.j.wiersma@amc.uva.nl
Verberne
Hein J
HJ
Trip
Mieke D
MD
ten Holt
Wik L
WL
van Eck-Smit
Berthe L F
BL
Piek
Jan J
JJ
Tijssen
Jan G P
JG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000150:complications* / Q000000981:diagnostic imaging*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017202:Myocardial Ischemia / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D055414:Myocardial Perfusion Imaging; D015428:Myocardial Reperfusion Injury / Q000150:complications / Q000000981:diagnostic imaging; D015995:Prevalence