당뇨병 환자에서 심근관류 SPECT을 이용한 관동맥질환의 진단: 위험인자 분석 (Diagnosis of Coronary Artery Disease using Myocardial Perfusion SPECT in Patients with Diabetes Mellitus: Analysis of Risk Factors) |
Author |
서지형*, 강성민, 배진호, 정신영, 이상우, 유정수, 안병철, 이재태, |
Ji-Hyoung Seo, M.D., Seong-Min Kang, M.D., Jin-Ho Bae, M.D., Shin-Young Jeong, M.D., Sang Woo Lee, M.D., Jeong-Soo Yoo, Ph.D., Byeong-Cheol Ahn, M.D. and Jaetae Lee, M.D. |
Affiliation |
경북대학교 의과대학 핵의학교실 Department of Nuclear Medicine, School of Medicine, Kyungpook National University, Daegu, Korea |
Abstract |
Purpose: Diabetes mellitus (DM) is a critical disease with higher rates of cardiovascular morbidity and mortality due to myocardial ischemia and infarction. There is growing interest in how to determine high-risk patients who are candidates for screening testing. This study was performed to evaluate the incidence of coronary artery disease (CAD) in diabetic patients detected by Tc-99m MIBI myocardial perfusion SPECT (MPS) and to assess risk factors of CAD and cardiac hard events. Subjects and Methods: 203 iabetic patients (64 male, mean age 64.1¡¾9.0 years) who underwent MPS were included between Jan 2000 and July 2004. Cardiac death and nonfatal myocardial infarction (MI) were considered as hard events, and coronary angioplasty and bypass surgery >60 days after testing were considered as soft events. The mean follow-up period was 36¡¾18 months. Patients underwent exercise (n=6) or adenosine stress (n=197) myocardial perfusion SPECT. Results: Perfusion defects on MPS were detected in 28.6% (58/203) of the patients. There was no ardiac death but 11 hard events were observed. The annual cardiac hard event rate was 1.1%. In univariate analysis of clinical factors, typical anginal pain, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were significantly associated with the ocurrence of hard events. Anginal pain, peripheral vascular disease, and resting ECG abnormality remained independent predictors of nonfatal MIs with multivariate analysis. Abnormal SPECT results were significantly associated with high prevalence of hard events but not independent predictors on uni- and multivariate analyses.
Conclusion: Patients who were male, had longer diabetes duration (especially over 20 years), peripheral vascular disease, peripheral polyneuropathy, or resting ECG abnormality had higher incidence of CAD. Among clinical factors in diabetic patients, typical angina, peripheral vascular disease, peripheral polyneuropathy, and resting ECG abnormality were strong predictors of hard events. (Nucl Med Mol Imaging 2006;40(3):155-162) |
Keyword |
coronary artery disease, diabetes mellitus, cardiac event, myocardial perfusion SPECT |
Full text Article |
4003155.pdf
|
|
|