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

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概要

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• 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)

• 2012-10-25

著者

• Kondo Chisato

  Department Of Diagnostic Imaging And Nuclear Medicine Tokyo Women's Medical University

• Nakajima Takatomo

  Department Of Cardiology Saitama Cardiovascular Center

• Hagiwara Nobuhisa

  Department Of Cardiology Heart Institute Of Japan Tokyo Women's Medical University

• Sato Asako

  Diabetes Center

• Sakai Shuji

  Department Of Clinical Radiology Graduate School Of Medical Sciences Kyushu University

• Fukushima Kenji

  Department Of Basic Biology The Graduate University For Advanced Studies

• Miyake Yoshiyuki

  Department Of Applied Chemistry Faculty Of Engineering Ehime University

• Uchigata Yasuko

  Diabetes Center Tokyo Women's Medical College

• Momose Mitsuru

  Department Od Radiology Tokyo Women's Medical University

• Momose Mitsuru

  Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University

• SATO Asako

  Diabetes Center, Tokyo Women's Medical University

• MIYAKE Yoshiyuki

  Department of Cardiology, Tokyo Women's Medical University

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