Impact of diabetes on viable myocardium in elderly coronary heart disease patients without myocardial infarction / 中华老年心脑血管病杂志

ABSTRACT

Objective To investigate the impact of diabetes on the surviving myocardium in elderly patients with coronary heart disease(CHD)but without myocardial infarction.Methods A total of 122 elderly patients admitted to our hospital from June 2019 to September 2022 and had been diagnosed with CHD but had not haven myocardial infarction were enrolled,and then divided into surviving myocardium group(68 cases)and non-surviving myocardium group(54 cases),and also divided into diabetic group(72 cases)and non-diabetic group(50 cases).Resting and exercise load myocardial perfusion single photon emission computed tomography and 18F-FDG myocardial posi-tron emission computed tomography were performed on all the patients to analyze the surviving myocardium and the influencing factors.Results The surviving myocardium group had signifi-cantly lower proportions of diabetes and obesity than the non-surviving myocardium group(33.8％vs 90.7％,P＜0.01;17.6％vs 38.9％,P＜0.01).The diabetic group presented obviously larger proportions of absence of activity,hypertension and obesity(P＜0.05,P＜0.01),while low-er ratios of viable myocardium in the anterior,inferior,lateral,and septal walls in each ischemia area(P＜0.01)when compared with the non-diabetic patients.Single factor logistic regression analysis showed that diabetes was a risk factor for increasing ratio of non-surviving myocardium in ischemic myocardial area(95％CI:6.721-54.703,P=0.001).Multifactor logistic regression analysis indicated that after adjusting for age and sex,and further adjusting for obesity,the rela-tive risk of diabetes was 24.564(95％CI:7.464-80.865,P=0.001).Conclusion Diabetes signifi-cantly reduces the amount of viable myocardium in the elderly CHD patients.It is recommended that for the CHD patients without myocardial infarction,especially those complicated with diabe-tes,evaluation for viable myocardium in ischemic area is essential.