title: The relationship between glycosylated hemoglobin and myocardial perfusion imaging.
abstract: BACKGROUND
  The relationship between long-term glucose control (measured by glycosylated hemoglobin [HgbA1C]) and myocardial perfusion imaging (MPI) abnormalities in symptomatic diabetic patients has not been studied.
  
  
  OBJECTIVE
  We hypothesized that diabetic patients with poorly controlled HgbA1C would have more abnormal MPI compared to both patients without diabetes and diabetic patients with tighter glycemic control.
  
  
  METHODS
  This was a retrospective evaluation of 1037 consecutive patients referred for MPI. All patients completed a 1-day MPI protocol. The electronic medical records were accessed for demographics and relevant medical history.
  
  
  RESULTS
  Diabetic patients had a higher risk of abnormal MPI (including ischemia, infarction, and mixed ischemia/infarction) compared to nondiabetic patients (relative risk [RR] = 1.77). The populations with suboptimal (HgbA1C ≥ 7%) and poor (HgbA1C ≥ 8%) glycemic control had significantly higher risk of abnormal MPI (RR = 1.78 and 2.17, respectively) compared to nondiabetic patients. Coronary angiography supported the MPI results; 66% of diabetic patients had coronary artery disease (CAD), which was higher than the 53% of patients without diabetes found to have CAD.
  
  
  CONCLUSIONS
  The importance of strict glycemic control to reduce cardiovascular complications in diabetic patients is well known. Our study shows a significantly higher risk of abnormal MPI and CAD in diabetic patients with suboptimal and poor long-term glycemic control, further emphasizing the need for aggressive risk factor modification to minimize vascular complications from DM.
authors: Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA. nml121180@yahoo.com
authors: Nicole M
authors: NM
authors: Lynn Fillipon
authors: Danai
authors: D
authors: Kitkungvan
authors: Sourbha S
authors: SS
authors: Dani
authors: Brian C
authors: BC
authors: Downey
mesh_terms: D000368:Aged; D016022:Case-Control Studies; D017023:Coronary Angiography; D003327:Coronary Disease / Q000517:prevention & control; D048909:Diabetes Complications / Q000517:prevention & control; D003920:Diabetes Mellitus / Q000097:blood* / Q000000981:diagnostic imaging; D005260:Female; D006442:Glycated Hemoglobin; D006801:Humans; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D006442:Glycated Hemoglobin