title: Prevalence of myocardial ischaemia as assessed with myocardial perfusion scintigraphy in patients with diabetes mellitus type 2 and mild anginal symptoms.
abstract: 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.
authors.affiliation: Department of Cardiology, Academic Medical Center, Amsterdam, The Netherlands. j.j.wiersma@amc.uva.nl
authors.forename: Jacobijne J
authors.initials: JJ
authors.lastname: Wiersma
authors.forename: Hein J
authors.initials: HJ
authors.lastname: Verberne
authors.forename: Mieke D
authors.initials: MD
authors.lastname: Trip
authors.forename: Wik L
authors.initials: WL
authors.lastname: ten Holt
authors.forename: Berthe L F
authors.initials: BL
authors.lastname: van Eck-Smit
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
mesh_terms: 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