title: Prognostic value of (123)I-betamethyl-p-iodophenyl-pentadecanoic acid single-photon emission computed tomography in diabetic patients with suspected ischemic heart disease.
abstract: BACKGROUND
  Because of their high risk for cardiovascular events, we investigated the role of (123)I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) SPECT in evaluating the prognosis of diabetic patients with suspected coronary heart disease.
  
  
  RESULTS
  We retrospectively registered 186 diabetic patients with suspected coronary heart disease, but no previous diagnosis of heart disease, who had been examined by BMIPP and thallium (TL) dual SPECT. They were followed for over 2 years. The dual SPECT images were scored to obtain summed defect scores for each SPECT image (BMDS, TLDS and mismatch score [MS]). The primary endpoint was the first incidence of all-cause cardiac events. The secondary endpoint was cardiac death. Clinical classical risk factors in addition to the stage of chronic kidney disease (CKD), as well as cardiac function, were included in the prognostic analysis. Cardiac events occurred in 39 patients, including 8 cardiac deaths. Kaplan-Meier analysis revealed significantly more frequent cardiac event rates in patients with than without MS ≥5 or BMDS ≥6 (P<0.0001). Cox hazard multivariate analysis showed that MS and CKD stage or BMIPP and CKD stage were independent predictors. Only hemodialysis was a significant prognostic indicator for cardiac death.
  
  
  CONCLUSIONS
  BMIPP SPECT when combined with CKD stage accurately predicts cardiac events among diabetic patients with suspected ischemic heart disease.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University, Tokyo, Japan. mmomose@rad.twmu.ac.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Momose
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Miyake
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukushima
authors.forename: Takatomo
authors.initials: T
authors.lastname: Nakajima
authors.forename: Chisato
authors.initials: C
authors.lastname: Kondo
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
authors.forename: Asako
authors.initials: A
authors.lastname: Sato
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Uchigata
authors.forename: Shuji
authors.initials: S
authors.lastname: Sakai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography / Q000009:adverse effects / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality; D003643:Death; D048909:Diabetes Complications / Q000000981:diagnostic imaging* / Q000401:mortality; D005227:Fatty Acids / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007462:Iodobenzenes / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011859:Radiography; D006435:Renal Dialysis / Q000009:adverse effects; D012189:Retrospective Studies; D012307:Risk Factors; D013793:Thallium / Q000008:administration & dosage
chemical_list: D005227:Fatty Acids; D007462:Iodobenzenes; C049338:iodofiltic acid; D013793:Thallium