Prognostic value of myocardial perfusion scintigraphy in patients with diabetes mellitus

ABSTRACT

Diabetes mellitus is a major risk factor for cardiovascular disease. Diabetics often have asymptomatic coronary artery disease that is less amenable to favorable interventional treatment compared with the non-diabetic population. Myocardial perfusion scintigraphy [MPS] is used widely to evaluate patients with suspected or known coronary artery disease. Prognosis and management can be assessed after the evaluation of coronary arteries and overall left ventricular systolic function. This study aimed to evaluate the role of MPS in the prediction of cardiac events in patients with diabetes mellitus. A prospective study was done on diabetic patients who underwent MPS in 2007. Patients were followed for at least 18 months after MPS. The occurrence of major and minor cardiac events was determined. A total of 149 patients were included in the study. Of the 114 patients with normal MPS findings only one patient had a minor cardiac event while the rest [99.1 %] had no events. On the other hand, of the 35 patients with abnormal findings, two [5.7%] patients had major cardiac events while 25 [71.4%] had minor cardiac events. The risk of developing a major cardiac event in patients with abnormal MPS is 4.4 times higher compared to those with normal MPS. The risk of developing a minor cardiac event in patients with abnormal MPS is 9.3 times higher compared to those with normal MPS. Myocardial perfusion imaging has a very high negative predictive value for any cardiac [99.1 %], minor cardiac [99.1 %], and major cardiac events [100%]. Diabetics with normal MPS findings have a very good prognosis.