title: Coronary artery disease in asymptomatic type-2 diabetic women. A comparative study between exercise test, cardiopulmonary exercise test, and dipyridamole myocardial perfusion scintigraphy in the identification of ischemia.
abstract: BACKGROUND
  Cardiovascular disease is the leading cause of morbidity and mortality among diabetic individuals. Myocardial ischemia is frequently asymptomatic, thus leading to a late diagnosis and worse prognosis. Diabetic women are known to have a cardiovascular death risk higher than that in men.
  
  
  OBJECTIVE
  To assess the prevalence of coronary artery disease (CAD) in asymptomatic diabetic women. To compare the results of exercise test (ET), cardiopulmonary exercise test (CPET), and dipyridamole myocardial perfusion scintigraphy (MPS) with the findings of coronary angiography, (ANGI) in order of identify the most accurate method in the detection of significant CAD.
  
  
  METHODS
  A total of 104 diabetic women were assessed with ET, CPET and MPS in the period within two months from the ANGI. MIBI-99mTc scintigraphy was performed using the gated-SPECT technique. Pearson's chi-square, Student's t tests were used for the statistical analysis and also the logistic regression analysis.
  
  
  RESULTS
  The prevalence of CAD in the group studied was 32.7%. For the ET, an effective test (p=0.045), the chronotropic incompetence (p=0.031), and the exercise time performed (p=0.022) showed a significant association with DAC. For CPET, peak VO2 and HR achieved were associated with CAD (p=0.004 and p=0.025, respectively). Most of the MPS variables showed a significant association with CAD (p=0.001, for all).
  
  
  CONCLUSIONS
  The results obtained may suggest a high prevalence of CAD in diabetic women. Thus, this population should be investigated from the cardiovascular point of view even without cardiac symptom. Of the noninvasive diagnostic methods used, dipyridamole MPS was the one that showed the highest discrimination power in relation to diabetic women with CAD.
authors: Instituto Dante Pazzanese de Cardiologia, Universidade Federal de São Paulo, São Paulo, SP, Brasil. paolaeps@cardiol.br
authors: Paola Emanuela Poggio
authors: PE
authors: Smanio
authors: Antonio Carlos
authors: AC
authors: Carvalho
authors: Antonio Sergio
authors: AS
authors: Tebexreni
authors: Anneliese
authors: A
authors: Thom
authors: Filadelfo
authors: F
authors: Rodrigues
authors: Romeu
authors: R
authors: Meneghelo
authors: Luiz
authors: L
authors: Mastrocolla
authors: Alexandre
authors: A
authors: Alves
authors: Leopoldo Soares
authors: LS
authors: Piegas
authors: Angelo Amato de
authors: AA
authors: Paola
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000592:standards; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000453:epidemiology; D004176:Dipyridamole; D005080:Exercise Test / Q000592:standards; D005260:Female; D006801:Humans; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D014665:Vasodilator Agents
chemical_list: D019275:Radiopharmaceuticals; D014665:Vasodilator Agents; D004176:Dipyridamole