Prevalence of coronary risk factors and myocardial perfusion scintigraphy abnormalities in asymptomatic diabetic outpatients.
OBJECTIVE
To determine the prevalence of coronary artery disease (CAD) risk factors (RF) and myocardial ischemia in a sample of asymptomatic diabetic patients treated on an outpatient basis.


METHODS
From 80 type 2 diabetic patients initially recruited at an university outpatient endocrinology clinic, with no symptoms and/or CAD diagnosis, only 61 patients completed the study protocol, being 52,5% females, with a mean age of 56.3 +/- 10.9 years. The patients were interviewed searching for RF and underwent electrocardiogram, echocardiogram and perfusional myocardial scintigraphy (PMS) at rest and under stress. According to the PMS results they were divided into two groups: an ischemic and a normal one .


RESULTS
The RF identified were: male gender (48%), age > or = 55 years (51%), family history of premature atherosclerotic disease (16%), history of smoking (46%), hypertension (44%), sedentary lifestyle (62%), overweight/obesity (67%), HDL- cholesterol < 45 mg/dl (69%), LDL- cholesterol > or = 100 mg/dl (85%) and triglycerides > or = 150 mg/dl (54%). Ischemic MPS were diagnosed in 15% of the patients. The variables associated with this diagnosis were: male gender (p=0.007), low HDL levels (p=0.046), history of smoking (p=0.038), left ventricular hypertrophy (LVH) (p=0.043) and left ventricle ejection fraction (LVEF) < 60% (p=0.01).


CONCLUSIONS
A high prevalence of associated RF was observed, as well as a significant prevalence of 15% for myocardial ischemia. The variables identified as predictors of a myocardial ischemia diagnosis were: male gender, low HDL-cholesterol, past smoking, LVH and LVEF < 60%.
Monteiro
Francisco das Chagas
Fd
Universidade Federal do Maranhão, São Luís, MA, Brasil. francchagas@cardiol.br
Cunha
Fhabyula da Silva
Fda S
Salgado Filho
Natalino
N
Barbosa
José Bonifácio
JB
Furtado
João Ribeiro
JR
Ferreira
Pedro Antônio Muniz
PA
Nina
Vinícius
V
Lages
Joyce
J
Santana
Nilton
N
D000368:Aged; D001938:Brazil / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004812:Epidemiologic Methods; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D010045:Outpatients / Q000706:statistics & numerical data; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D012737:Sex Factors; D017256:Technetium Tc 99m Sestamibi
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019275:Radiopharmaceuticals; D017256:Technetium Tc 99m Sestamibi