Screening of silent myocardial ischemia in asymptomatic diabetic patients: ROle of coronary artery calcium and stress myocardial perfusion scintigraphy - 25/12/18
Résumé |
Background |
Coronary artery diseases and heart failure are the main causes of morbimortality in diabetes. Screening of silent myocardial ischemia in asymptomatic diabetic patients is very important and is still controversial.
Coronary artery calcium (CAC) belongs to innovative technology in non-invasive imagery technique based on tomography without injection and permits cardiovascular risk assessment; its threshold usually is 400.
Purpose |
Principal objective was to diagnose silent myocardial ischemia in asymptomatic diabetics based on CAC measurement.
A secondary objective was to determine patients’ characteristics when CAC was<or≥400.
Methods |
CAC imaging was performed in every asymptomatic diabetic patient and all patients with CAC≥400 underwent myocardial perfusion scintigraphy.
Results |
Two hundred and sixty-three patients were included between 2014 and 2017. Eighty patients had a CAC score≥400 and sixty-two of them underwent myocardial perfusion scintigraphy. Silent myocardial ischemia was detected in 14 patients (5%).
The predictors of elevated CAC were: age, male gender, hypertension, duration of diabetes, dyslipidemia and microalbuminuria.
Conclusion |
In this study, evaluating silent ischemia screening, CAC followed by myocardial scintigraphy have an important role in cardiovascular risk assessment. Thirty percent of patients required an imaging test such as perfusion scintigraphy and 5% had silent myocardial ischemia.
CAC and myocardial perfusion scintigraphy can improve screening and risk stratification in this population.
CAC score can help to guide medical treatment.
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Vol 11 - N° 1
P. 21 - janvier 2019 Retour au numéro
Article précédent
- Short and long-term prognostic value of admission glycosylated hemoglobin and plasma glucose in nondiabetic patients with acute myocardial infarction
- B. Mouhat, M. Zeller, B. Vergès, F. Chagué, J.C. Beer, M. Maza, Y. Cottin
- Long term prognostic impact of myocardium at risk and CTO presence in the setting of myocardial infarction complicated by out-of-hospital cardiac arrest
- G. Sideris, N. Magkoutis, Sébastian Voicu, Jean-Guillaume Dillinger, Damien Logeart, Patrick Henry
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