title: Interrelationship between myocardial perfusion imaging, coronary calcium score, and endothelial function in asymptomatic diabetics and controls.
abstract: BACKGROUND
  Coronary artery disease is a leading cause of death among diabetics, and silent ischemia is a major concern in patients with diabetes mellitus (DM).
  
  
  METHODS
  To detect the prevalence of ischemia in diabetics by myocardial perfusion imaging (MPI), and compare it to a control group without DM but with coronary risk factors, as well as to explore the relationship between silent ischemia, endothelial dysfunction, and coronary calcium, 59 patients (Group I) and 42 controls (Group II) were included. All underwent clinical and laboratory evaluations, gated MPI, brachial artery vasodilation measured by ultrasonography, and coronary calcium score (CCS).
  
  
  RESULTS
  Twenty diabetics showed perfusion defects, vs seven controls (P = .04). There was no significant difference between both groups regarding the brachial artery vasodilator responsiveness: 4.49% ± 4.26% (diabetics) vs 4.70% ± 4.98% (controls). Mean CCS was 74 in diabetics vs five in controls (P = .01). The only risk factor significantly associated with an abnormal MPI was the presence of diabetes (P = .03). In the whole population of patients and in diabetics, the abnormal endothelium-dependent vasodilation, the CCS >100, and the cholesterol/HDL ratio >4, showed an OR >1. CCS exhibited the higher OR among the whole population: OR 2.15 [95% CI 0.42-10.99]; while for diabetics it was the cholesterol/HDL ratio: OR 3.95 [95% CI 0.71-21.84].
  
  
  CONCLUSIONS
  Reversible perfusion defects and coronary calcium are more frequent in diabetics. CCS, abnormal endothelium-dependent vasodilation, and cholesterol/HDL ratio higher than 4, showed an association with perfusion abnormalities in asymptomatic diabetics.
authors: Nuclear Medicine Department, Institute of Cardiology, 17 No. 702, Vedado, CP 10 400, La Habana, Cuba. peix@infomed.sld.cu
authors: Amalia
authors: A
authors: Peix
authors: Lázaro O
authors: LO
authors: Cabrera
authors: Flor
authors: F
authors: Heres
authors: Lydia
authors: L
authors: Rodríguez
authors: Alexander
authors: A
authors: Valdés
authors: Juan
authors: J
authors: Valiente
authors: Raymid
authors: R
authors: García
authors: Manuel
authors: M
authors: Licea
authors: Vladimir
authors: V
authors: Mendoza
authors: Francisco
authors: F
authors: Gárciga
authors: Yaquelin
authors: Y
authors: Rodríguez
authors: Regla
authors: R
authors: Carrillo
authors: Erick
authors: E
authors: Mena
authors: Yoel
authors: Y
authors: Fernández
authors: Minerva
authors: M
authors: Montero
authors: Maurizio
authors: M
authors: Dondi
mesh_terms: D000328:Adult; D002114:Calcinosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D003462:Cuba / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D055414:Myocardial Perfusion Imaging / Q000706:statistics & numerical data; D015995:Prevalence; D015899:Tomography, Emission-Computed, Single-Photon / Q000706:statistics & numerical data