SPECT predicts CV events and death in asymptomatic Type 2 diabetics
MedWire News: Type 2 diabetes patients with gated myocardial perfusion single-photon computed tomography (SPECT) imaging abnormalities who are otherwise asymptomatic are at high risk for cardiovascular (CV) events and death, say researchers.
The Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT (J-ACCESS) study previously showed diabetes to be the most important predictor of CV events in Japan.
Yoshimitsu Yamasaki (Osaka University, Suita, Japan) and co-workers therefore used SPECT imaging, which was recently validated for detecting myocardial ischemia and assessing prognosis, to stratify 485 at-risk, but asymptomatic, Type 2 diabetes patients into high and low CV risk categories.
Those with a SPECT summed stress score (SSS) of less than 9 were considered to have normal or mildly abnormal results and those with a score of 9 or more to have moderately or severely abnormal results, as described in the J-ACCESS trial.
The cohort was then followed up for 3 years, during which time five cardiac deaths and 57 CV events (heart failure, revascularization, angina, transient ischemic attack, stroke, and peripheral artery disease) occurred.
Patients with a SSS score of 9 or more had a significantly higher incidence of death or CV events than those with lower scores, at 23% versus 12%. Other significant risk factors were having a low estimated glomerular filtration rate and being a current smoker.
"The prevalence of diabetes in the Japanese population is rapidly increasing as the lifestyle becomes more Westernized. Therefore, the cardiovascular event rate among asymptomatic diabetic Japanese patients is a matter of considerable concern," write the researchers.
"The present data indicate that myocardial ischemia would be useful for risk stratification of cardiovascular events in asymptomatic diabetic patients," they suggest.
The results of this study are published in the journal Diabetes Care.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010
By Helen Albert