title: Prognostic value of myocardial perfusion imaging for cardiovascular events among asymptomatic Japanese patients with type 2 diabetes and mild renal dysfunction.
abstract: BACKGROUND
  Diabetes is frequently accompanied by chronic kidney disease, and both diabetes and chronic kidney disease are risk factors for ischemic heart disease; however, cardiac risk among diabetic patients with mild renal dysfunction has not been analyzed in detail. The present study investigates how myocardial perfusion imaging (MPI) contributes to the risk stratification of diabetic patients with mild renal dysfunction who are asymptomatic for cardiac diseases.
  
  
  METHODS
  Among 513 asymptomatic patients with type 2 diabetes in the Japanese Assessment of Cardiac Events and Survival Study 2 (J-ACCESS) database, we selected 286 with estimated glomerular filtration rates (eGFR) of at least 45 ml/min/1.73 m and assigned them to groups on the basis of eGFR of at least 60 without (group A, n=66) or with microalbuminuria or eGFR 45 to less than 60 (group B, n=220). The 3-year incidence of cardiac events and the value of MPI were evaluated.
  
  
  RESULTS
  Cardiac events developed in 1.52 and 4.55% of patients in groups A and B, respectively. Event-free survival did not differ according to summed stress scores in group A but was significantly lower among patients with summed stress scores of at least 9 in group B.
  
  
  CONCLUSIONS
  Routine MPI might be useful for stratifying risk among diabetic patients with mild renal dysfunction but is unnecessary for those with good renal function.
authors: Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan. chio@koto.kpu-m.ac.jp
authors: Chio
authors: C
authors: Okuyama
authors: Kenichi
authors: K
authors: Nakajima
authors: Yoshimitsu
authors: Y
authors: Yamasaki
authors: Tsunehiko
authors: T
authors: Nishimura
mesh_terms: D000368:Aged; D044466:Asian People; D058070:Asymptomatic Diseases; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology; D015331:Cohort Studies; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000503:physiopathology*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D055414:Myocardial Perfusion Imaging; D018570:Risk Assessment; D013312:Stress, Physiological; D015899:Tomography, Emission-Computed, Single-Photon