TITLE

CLINICAL UTILITY OF CORONARY CALCIUM SCORING IN DIABETIC PATIENTS WITH NORMAL OR MILD ISCHEMIA IN MYOCARDIAL PERFUSION SCINTIGRAPHY

AUTHOR(S)
El-Guindy, Amr; Nassar, Ahmed; El-Rahman, Ahmed Abd; Aziz, Mohamed Abdel
PUB. DATE
November 2011
SOURCE
International Journal of Academic Research;Nov2011, Vol. 3 Issue 6, p249
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Diabetic patients have a high prevalence of coronary atherosclerosis, once CAD is manifested clinically; diabetic patients continue to have a worse prognosis compared with non-diabetic patients both acutely after the event and during long-term follow-up. So detection of coronary artery disease before the first myocardial infarction and before anginal symptoms will allow for strategies designed to reduce the cardiovascular event rate in this group of patients. Objectives: This study was done to test the ability to predict the presence of angiographically determined coronary artery disease (CAD) in diabetic subjects by quantification of coronary calcium using Multi-slice computed tomography (MSCT) and to compare it with more conventional parameters as, cardiovascular risk factors and radionuclide single-photon emission computed tomography (SPECT). Methods: A total number of 60 diabetic subjects without prior cardiovascular disease with normal or mild ischemia according to myocardial perfusion SPECT interpretation were scheduled for elective conventional coronary angiography after obtaining their coronary artery calcium scores. Findings of myocardial perfusion imaging (MPI) & coronary calcifications were compared to those of conventional angiograms. Evaluation was performed, using the results of selective coronary angiography as the gold standard. Results: The frequency in the presence of coronary artery stenosis rose with increasing CAC scores (p < 0.001), in contrast to the presence of mild ischemia on MPI with increasing CAC scores which showed a less powerful relation (p< 0.04). Coronary artery intervention was only required by subjects with coronary artery calcification >400 (p<0.001). Conclusion: Our results suggest that coronary calcification is a strong and independent predictor of coronary disease. Risk stratification by assessment of coronary calcification may have an important role in the primary prevention of coronary heart disease in diabetic patients.
ACCESSION #
80232508

 

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