title: Improved lipid profiles are associated with reduced incidence of coronary vascular events in asymptomatic patients with type 2 diabetes and impaired myocardial perfusion.
abstract: OBJECTIVE
  Individuals with type 2 diabetes are at high risk for cardiovascular events; however, a modality that could reduce risk has not been fully evaluated. We examined the annual incidence rate of cardiovascular events in asymptomatic Japanese diabetic patients who underwent gated myocardial perfusion single-photon computed tomography (SPECT).
  
  
  METHODS
  Asymptomatic patients (n= 485) aged ≥50 years and with either a maximal carotid artery intima-media thickness of ≥1.1 mm, or urinary albumin ≥30 mg/g creatinine, or at least two of abdominal obesity, low HDL cholesterol, high triglyceride levels and hypertension were evaluated at 50 institutions using gated SPECT with the stress-rest protocol and were followed up for three years. In the patients with summed stress scores (SSS) of ≥9, the initial high cardiovascular incidence rate in the first year declined significantly (p<0.001) from 21% to 2% during the second and third year.
  
  
  RESULTS
  The incident rate was consistent among diabetics with low SSS during follow-up. Baseline LDL and non-HDL cholesterol levels significantly reduced (123±6.4 to 99±6.1 mg/dL; p<0.05) during the first year in diabetic patients with high SSS, but did not significantly change in diabetic patients with low (<9) SSS.
  
  
  CONCLUSIONS
  The immediate improvement of lipid levels within one year correlated with the significant reduction in CVD events arising in diabetic patients with moderate or severe myocardial ischemia. Thus, rapidly lowering hyperlipidemia is very effective for patients with type 2 diabetes at high risk for cardiac events.
authors.affiliation: Department of Endocrinology and Metabolism, Osaka University, Suita, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Yamasaki
authors.forename: Naoto
authors.initials: N
authors.lastname: Katakami
authors.forename: Hideaki
authors.initials: H
authors.lastname: Kaneto
authors.forename: Kenichi
authors.initials: K
authors.lastname: Nakajima
authors.forename: Hideo
authors.initials: H
authors.lastname: Kusuoka
authors.forename: Atsunori
authors.initials: A
authors.lastname: Kashiwagi
authors.forename: Tsunehiko
authors.initials: T
authors.lastname: Nishimura
mesh_terms: D055426:Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D003327:Coronary Disease / Q000209:etiology* / Q000517:prevention & control; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000000981:diagnostic imaging*; D006801:Humans; D008055:Lipids / Q000097:blood*; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications*; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008055:Lipids; D014280:Triglycerides