title: Prognostic implications of myocardial perfusion imaging and coronary calcium score in a Macedonian cohort of asymptomatic patients with type 2 diabetes.
abstract: Type 2 diabetes is a risk factor for coronary artery disease; however, a number of studies have shown that patients are asymptomatic for coronary artery disease. The presence of coronary artery disease in asymptomatic patients with type 2 diabetes was evaluated to determine its impact on management decision and prognosis.
  
  
  
  A total of 75 patients underwent single-photon emission computed tomography myocardial perfusion imaging for detection of suspected coronary artery disease. We used 17-segment model for perfusion and function analysis. Multislice computed tomography was performed in 45 patients to assess coronary artery calcium. Complete laboratory analyses with lipid values and standard risk factors were analysed. Forward logistic regression analysis was used to assess predictive parameters for myocardial ischaemia during the follow-up period of 20 ± 4 months.
  
  
  
  Silent myocardial ischaemia and subclinical coronary artery disease can be detected in a significant proportion of asymptomatic patients with type 2 diabetes. Diabetic patients with normal myocardial perfusion imaging had an excellent 2-year prognosis with optimal medical therapy and intensive risk factor control. In comparison, an abnormal myocardial perfusion imaging led to an increased risk of cardiovascular events. Myocardial perfusion imaging and coronary artery calcium are valuable tools for risk stratification and optimal treatment decision in this asymptomatic diabetic cohort of Macedonian patients.
authors.affiliation: 1 University Cardiology Clinic, Institute for Pathophysiology and Nuclear Medicine, Skopje, Macedonia.
authors.forename: Irena Peovska
authors.initials: IP
authors.lastname: Mitevska
authors.affiliation: 1 University Cardiology Clinic, Institute for Pathophysiology and Nuclear Medicine, Skopje, Macedonia.
authors.forename: Natalija
authors.initials: N
authors.lastname: Baneva
authors.affiliation: 1 University Cardiology Clinic, Institute for Pathophysiology and Nuclear Medicine, Skopje, Macedonia.
authors.forename: Elizabeta
authors.initials: E
authors.lastname: Srbinovska
authors.affiliation: 2 Centre for Chronic Disease, College of Health & Biomedicine, Victoria University, Melbourne, VIC, Australia.
authors.forename: Lily
authors.initials: L
authors.lastname: Stojanovska
authors.affiliation: 2 Centre for Chronic Disease, College of Health & Biomedicine, Victoria University, Melbourne, VIC, Australia.
authors.forename: Vasso
authors.initials: V
authors.lastname: Apostolopoulos
authors.affiliation: 1 University Cardiology Clinic, Institute for Pathophysiology and Nuclear Medicine, Skopje, Macedonia.
authors.forename: Marijan
authors.initials: M
authors.lastname: Bosevski
mesh_terms: D000368:Aged; D058070:Asymptomatic Diseases; D016009:Chi-Square Distribution; D000072226:Computed Tomography Angiography; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000175:diagnosis; D003925:Diabetic Angiopathies / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D016017:Odds Ratio; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018843:Republic of North Macedonia; D012307:Risk Factors; D000072098:Single Photon Emission Computed Tomography Computed Tomography; D013997:Time Factors; D061205:Vascular Calcification / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology
keywords: Type 2 diabetes; coronary artery disease; coronary calcium score; myocardial ischaemia; myocardial perfusion imaging