Retinal vessel abnormalities predict coronary artery diseases.

BACKGROUND: There are limited data supporting an association between retinal microvascular changes and cardiovascular mortality, but there is no convincing evidence of an independent or direct association with atherosclerosis in coronary artery disease (CAD) patients. The present study examines the relationship between retinal microvascular changes and angiographic findings. METHODS: Patients who were candidates for angiography were, at first, referred to the ophthalmology department for the determination of the severity of retinal atherosclerosis based on the Scheie classification. Angiography was carried out afterwards. Each patient completed a questionnaire, also providing information on risk factors. For each patient, the Gensini score was calculated using angiography findings. RESULTS: A total of 168 patients (99 males and 69 females) with a mean age of 55.3±11.9 years were included in this study. The results show a significant association between CAD severity and retinal artery atherosclerosis (r = 0.47, p = 0.0001). In multiple regression analyses with CAD severity (using Gensini scoring) as a dependent variable, we observed a significant association between atherosclerosis scores based on Scheie criteria (ß=0.31, p<0.0001), diabetes mellitus (DM) (ß=0.29, p<0.0001), hypertension (ß=0.23, p<0.0001), smoking (ß=0.20, p<0.0001), and age (ß=0.15, p<0.0001). CONCLUSIONS: The results demonstrate that fundoscopic changes might be a predictor of CADs. However, more well-designed studies to verify these results are still needed.

Myocardial perfusion imaging using technetium-99m sestamibi in asymptomatic diabetic patients.

UNLABELLED: Myocardial perfusion single-photon emission computed tomography (SPECT) has been extensively applied in the clinical assessment of patients with diabetes mellitus. The aim of the present study was to evaluate stress technetium-99m sestamibi SPECT MPI perfusion in silent myocardial ischemia and its association with some clinical and laboratory parameters in an asymptomatic diabetic population. PATIENTS, MATERIAL, METHODS: 83 subjects (age: 57.1±6.9 years) with at least five years history of type 2 diabetes, and no suspected or documented coronary artery disease (CAD) accomplished myocardial perfusion imaging; angiography was also performed in patients with abnormal MPI. RESULTS: MPI results showed that 58 patients had normal myocardial perfusion, while 25 patients showed perfusion defects (23 reversible and 2 fixed) on MPI. 12 out of the 25 (48%) with abnormal MPI findings represented abnormal angiography. We observed that pretest likelihood of CAD (odds ratio 2.32; 95%-CI: 1.05-5.13; p = 0.038) and higher HbA1c level (odds ratio 1.70; 95%-CI, 1.07-2.71; p = 0.02) were independently associated with abnormal MPI. CONCLUSION: Occult CAD was present on MPI in 1/3 patients with DM without abnormal electrocardiographic findings or evidence of peripheral arterial disease.