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Titolo:
Comparative ability of myocardial perfusion single-photon emission computed tomography to detect coronary artery disease in patients with and withoutdiabetes mellitus
Autore:
Kang, XP; Berman, DS; Lewin, H; Miranda, R; Erel, J; Friedman, JD; Amanullah, AM;
Indirizzi:
Univosalif Los Angeles, Cedars Sinai Med Ctr, Dept Imaging, Div Nucl Med, L Univ Calif Los Angeles Los Angeles CA USA 90048 Imaging, Div Nucl Med, L Univgeles, Los Angeles, Cedars Sinai Med Ctr, Dept Med, Div Cardiol, Los An Univ Calif Los Angeles Los Angeles CA USA 90048 Med, Div Cardiol, Los An UnivUSAlif Los Angeles, CSMC Burns & Allen Res Inst, Los Angeles, CA 90048Univ Calif Los Angeles Los Angeles CA USA 90048 st, Los Angeles, CA 90048 Univ Calif Los Angeles, Dept Med, Los Angeles, CA 90048 USA Univ Calif LosAngeles Los Angeles CA USA 90048 Los Angeles, CA 90048 USA
Titolo Testata:
AMERICAN HEART JOURNAL
fascicolo: 5, volume: 137, anno: 1999,
pagine: 949 - 957
SICI:
0002-8703(199905)137:5<949:CAOMPS>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
TC-99M SESTAMIBI; EXERCISE; SPECT; COMPLICATIONS; SCINTIGRAPHY; DIAGNOSIS; EFFICACY; SEPARATE; ISCHEMIA; EXTENT;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Berman, DS Univ700lif Los Angeles, Cedars Sinai Med Ctr, Dept Imaging, DivNucl Med, 8 Univ Calif Los Angeles 8700 Beverly Blvd,Room A042 Los AngelesCA USA 90048
Citazione:
X.P. Kang et al., "Comparative ability of myocardial perfusion single-photon emission computed tomography to detect coronary artery disease in patients with and withoutdiabetes mellitus", AM HEART J, 137(5), 1999, pp. 949-957

Abstract

Background Diabetics generally have more frequent and extensive silent myocardial ischemia than nondiabetics, increasing the importance of noninvasive detection of coronary artery disease (CAD) in this cohort. However, little is known regarding the diagnostic accuracy of myocardial perfusion single-photon emission computed tomography (SPECT) in patients with diabetes. This study was undertaken to compare the diagnostic value of rest thallium-201/stress technetium-99m sestamibi dual-isotope myocardial perfusion SPECT inpatients with and without diabetes. Methods of the 203 patients with diabetes and 260 patients without diabetes who underwent dual-isotope myocardial perfusion SPECT with exercise or pharmacologic stress testing, 138 diabetics (12% type 1 diabetics) and 188 nondiabetics had coronary angiography within 6 months of the nuclear test, and 65 diabetics and 72 nondiabetics had a low likelihood (<10%, mean 6% +/- 3% and 6% +/- 3%) of CAD. Results The angiographic data showed that patients with diabetes had less incidence of 1-vessel disease and a higher incidence of 3-vessel/left main artery disease than patients without diabetes (P < .05). The overall sensitivity and specificity, respectively, of SPECT For detecting CAD with the criterion of greater than or equal to 50% diameter stenosis were 86% (95 of 111) and 56% (15 of 27) in diabetics, 86% (122 of 142) and 46% (21 of 46) innondiabetics (P = not significant). With the criterion of greater than or equal to 70% diameter stenosis the corresponding results were 90% (86 of 96) and 50% (21 of 42) in diabetics, and 91% (108 of 119) and 43% (30 of 69) in nondiabetics, respectively (P = not significant). The normalcy rate For low likelihood patients was 89% (58 of 65) in diabetics and 90% (65 of 72) in nondiabetics (P = not significant). The sensitivity and specificity for individual vessel detection were also similar in patients with and without diabetes (P = not significant) except for a lower sensitivity and a higher specificity for detecting left anterior descending coronary artery disease in the diabetic group (P < .05). Conclusion Dual-isotope myocardial perfusion SPECT has comparable accuracyfor the diagnosis of CAD in diabetic and nondiabetic patients.

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Documento generato il 04/04/20 alle ore 09:01:49