Prognostic value of normal stress myocardial perfusion imaging and ventricular function in Japanese asymptomatic patients with type 2 diabetes: A study based on the J-ACCESS-2 database

フォーマット:

論文

責任表示:

Matsuo, Shinro ; Nakajima, Kenichi ; Yamasaki, Yoshimitsu ; Kashiwagi, Atsunori ; Nishimura, Tsunehiko

言語:

英語

出版情報:

日本循環器学会, 2010-01-01

著者名:

• Matsuo, Shinro
• Nakajima, Kenichi
• Yamasaki, Yoshimitsu
• Kashiwagi, Atsunori
• Nishimura, Tsunehiko

掲載情報:

Circulation Journal

ISSN:

1346-9843      

巻:

74

通号:

9

開始ページ:

1916

終了ページ:

1921

バージョン:

publisher

概要:

金沢大学附属病院核医学診療科<br />Background: This study was designed to determine the clinical risk for hard events after normal single-photon emission computed tomography (SPECT) and to identify the predictors of increased risk in asymptomatic pa … tients with diabetes mellitus, based on a Japanese Assessment of Cardiac Events and Survival Studies by quantitative gated SPECT (J-ACCESS)-2 study. Methods and Results: A total of 513 consecutive asymptomatic patients who underwent stress 99 mTc-tetrofosmin SPECT in Japan were included in this study. Based on SPECT image and QGS data, 319 had a summed stress score ≤3, a summed difference score <2 and normal cardiac function (end-systolic volume ≤60 ml, males, ≤40 ml, females; left ventricular ejection fraction ≥49%, males, ≥50%, females). Myocardial perfusion was normal in 62% of this study population. During a 3-year follow-up, there were a total of 8 cardiac major events (2.5%): 2 cases of sudden death, 5 of acute coronary syndrome, and 1 of hospitalization because of congestive heart failure. The annual major event rate was 0.8%. Subjects undergoing coronary angiography had significantly more major events than those who did not among normal SPECT subjects (P=0.01). Kaplan-Meier analysis showed that the cardiac major events rate was very low, and subjects with normal SPECT can be considered as low risk among asymptomatic patients with diabetes. Conclusions: An excellent prognosis was associated with a normal SPECT in asymptomatic patients with diabetes, so these patients can be exempted from further invasive procedure. 続きを見る

URL:

http://hdl.handle.net/2297/25208