SPECT in asymptomatic diabetics with and without microalbuminuria.
OBJECTIVE
To identify coronary artery disease (CAD) in asymptomatic diabetics with the help of myocardial perfusion single photon emission computed tomography (MPS), a non-invasive imaging modality and its correlation in diabetics with or without microalbuminuria.


METHODS
This study included 99 patients in the age group of 30 to 80 years who were asymptomatic but possessed one or more risk factors for CAD. These patients were divided into two groups, diabetics with and without microalbuminuria (Micral). Thirty eight patients were Micral positive and 61 were Micral negative. Ischemia was detected by MPS and compared with coronary angiographic findings in both the groups.


RESULTS
Amongst the 99 diabetic patients, MPS was positive in 39 patients. Out of 39 MPS positive patients, 31(79.5%) were micral positive and 8 (20.5%) were micral negative. Out of 38 micral positive patients, 31 patients were positive on MPS and 27 had significant angiographic (CAG) findings. Those with micral positive and MPS positive had multivessel CAD by CAG. It was seen that MPS status was 91.4% sensitive, 74.1% specific and had 82.1% positive predictive values (PPV) and 87.0% negative predictive value (NPV) for detection of significant CAD.


CONCLUSIONS
Microalbuminuria is an inexpensive screening tool and a powerful independent predictor for major cardiovascular events in patients with type 2 diabetes mellitus. MPS is a sensitive, non invasive diagnostic test for identification of CAD in asymptomatic diabetic patients.
Department of Nuclear Medicine, Apollo Hospital, Chennai 600006.
Shashwat
S
Verma
Department of Cardiology, Apollo Hospital, Chennai 600006.
I
I
Sathyamurthy
Department of Nuclear Medicine, Apollo Hospital, Chennai 600006.
S
S
Shelley
Department of Nuclear Medicine, Apollo Hospital, Chennai 600006.
M
M
Indirani
Department of Nuclear Medicine, Apollo Hospital, Chennai 600006.
Alok S
AS
Pawaskar
Department of Nuclear Medicine, Apollo Hospital, Chennai 600006.
K
K
Jayanthi
Department of Cardiology, Apollo Hospital, Chennai 600006.
P
P
Ramachandran
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000150:complications*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000209:etiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D015899:Tomography, Emission-Computed, Single-Photon