title: Myocardial perfusion imaging for evaluation of suspected ischemia and its relationship with glycemic control in South African subjects with diabetes mellitus.
abstract: BACKGROUND
  The relationship between myocardial perfusion imaging (MPI) abnormalities, diabetes mellitus, and glucose control in South African populations is unknown. It was hypothesized that in subjects undergoing MPI for suspected coronary artery disease (CAD), those with diabetes would have more extensive perfusion defects and that diabetes control would influence MPI abnormalities. The aim of this study was to examine the relationship between the severity of CAD diagnosed with MPI in subjects with and without diabetes and to determine the relationship between diabetes control and extent of CAD.
  
  
  METHODS
  This study was a retrospective chart review of 340 subjects in whom MPI scans were performed over a 12-month period.
  
  
  RESULTS
  Subjects with diabetes had a higher prevalence of abnormal MPI, with more extensive ischemia, compared with subjects without diabetes (85.6% versus 68%; odds ratio 2.81, P<0.01). Glycated hemoglobin ≥7.0% was associated with a higher risk of abnormal MPI, with more extensive ischemia, compared with subjects having diabetes and glycated hemoglobin <7.0% (odds ratio 2.46, P=0.03) and those without diabetes (odds ratio 4.55, P=0.0001).
  
  
  CONCLUSIONS
  Subjects with diabetes have more extensive myocardial ischemia when compared with subjects without diabetes. Furthermore, poorer diabetes control is associated with more abnormalities on MPI scanning.
authors.affiliation: Department of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Akram
authors.initials: A
authors.lastname: Shmendi
authors.affiliation: Department of Diabetes and Endocrinology, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Fraser
authors.initials: F
authors.lastname: Pirie
authors.affiliation: Department of Cardiology, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Datshana P
authors.initials: DP
authors.lastname: Naidoo
authors.affiliation: Department of Biostatistics, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Boikhutso
authors.initials: B
authors.lastname: Tlou
authors.affiliation: Department of Nuclear Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Wilfred
authors.initials: W
authors.lastname: Pilloy
authors.affiliation: Department of Diabetes and Endocrinology, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Ayesha A
authors.initials: AA
authors.lastname: Motala
keywords: coronary artery disease; diabetes mellitus; glycated hemoglobin; myocardial perfusion imaging