Prognostic Value of <sup>123</sup>I-Betamethyl-p-Iodophenyl-Pentadecanoic Acid Single-Photon Emission Computed Tomography in Diabetic Patients With Suspected Ischemic Heart Disease

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  • Momose Mitsuru
    Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University
  • Miyake Yoshiyuki
    Department of Cardiology, Tokyo Women’s Medical University Department of Cardiology, Tokyo Women’s Medical University
  • Fukushima Kenji
    Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University
  • Nakajima Takatomo
    Department of Cardiology, Tokyo Women’s Medical University Department of Cardiology, Tokyo Women’s Medical University
  • Kondo Chisato
    Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University
  • Hagiwara Nobuhisa
    Department of Cardiology, Tokyo Women’s Medical University Department of Cardiology, Tokyo Women’s Medical University
  • Sato Asako
    Diabetes Center, Tokyo Women’s Medical University Diabetes Center, Tokyo Women’s Medical University
  • Uchigata Yasuko
    Diabetes Center, Tokyo Women’s Medical University Diabetes Center, Tokyo Women’s Medical University
  • Sakai Shuji
    Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women’s Medical University

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Description

Background: Because of their high risk for cardiovascular events, we investigated the role of 123I-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.  (Circ J 2012; 76: 2633–2639)<br>

Journal

  • Circulation Journal

    Circulation Journal 76 (11), 2633-2639, 2012

    The Japanese Circulation Society

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