Prognostic value of (123)I-betamethyl-p-iodophenyl-pentadecanoic acid single-photon emission computed tomography in diabetic patients with suspected ischemic heart disease.

Abstract

BACKGROUND:

Because of their high risk for cardiovascular events, we investigated the role of (123)I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) SPECT in evaluating the prognosis of diabetic patients with suspected coronary heart disease.

METHODS AND RESULTS:

We retrospectively registered 186 diabetic patients with suspected coronary heart disease, but no previous diagnosis of heart disease, who had been examined by BMIPP and thallium (TL) dual SPECT. They were followed for over 2 years. The dual SPECT images were scored to obtain summed defect scores for each SPECT image (BMDS, TLDS and mismatch score [MS]). The primary endpoint was the first incidence of all-cause cardiac events. The secondary endpoint was cardiac death. Clinical classical risk factors in addition to the stage of chronic kidney disease (CKD), as well as cardiac function, were included in the prognostic analysis. Cardiac events occurred in 39 patients, including 8 cardiac deaths. Kaplan-Meier analysis revealed significantly more frequent cardiac event rates in patients with than without MS ≥5 or BMDS ≥6 (P<0.0001). Cox hazard multivariate analysis showed that MS and CKD stage or BMIPP and CKD stage were independent predictors. Only hemodialysis was a significant prognostic indicator for cardiac death.

CONCLUSIONS:

BMIPP SPECT when combined with CKD stage accurately predicts cardiac events among diabetic patients with suspected ischemic heart disease.

• Authors: Mitsuru Momose, Yoshiyuki Miyake, Kenji Fukushima, Takatomo Nakajima, Chisato Kondo, Nobuhisa Hagiwara, Asako Sato, Yasuko Uchigata, Shuji Sakai
• Journal: Circulation journal : official journal of the Japanese Circulation Society (Circ J) Vol. 76 Issue 11 Pg. 2633-9 ( 2012) ISSN: 1347-4820 [Electronic] Japan
• PMID: 22864180 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Fatty Acids
• Iodobenzenes
• iodofiltic acid
• Thallium

Topics

• Aged
• Aged, 80 and over
• Cardiac-Gated Single-Photon Emission Computer-Assisted Tomography (adverse effects, methods)
• Coronary Artery Disease (diagnostic imaging, mortality)
• Death
• Diabetes Complications (diagnostic imaging, mortality)
• Fatty Acids (administration & dosage, adverse effects)
• Female
• Humans
• Iodobenzenes (administration & dosage, adverse effects)
• Male
• Middle Aged
• Radiography
• Renal Dialysis (adverse effects)
• Retrospective Studies
• Risk Factors
• Thallium (administration & dosage)