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- Title
Dobutamine stress myocardial perfusion imaging: 8-year outcomes in patients with diabetes mellitus.
- Authors
Boiten, Hendrik J.; van Domburg, Ron T.; Valkema, Roelf; Zijlstra, Felix; Schinkel, Arend F. L.
- Abstract
Aims Many studies have examined the prognostic value of myocardial perfusion imaging (MPI) using single-photon emission computed tomography (SPECT) for the prediction of short- to medium-term outcomes. However, the long-term prognostic value of MPI in patients with diabetes mellitus remains unclear. Therefore, this study assessed the long-term prognostic value of MPI in a high-risk cohort of patients with diabetes mellitus. Methods A high-risk cohort of 207 patients with diabetes mellitus who were unable to undergo exercise testing underwent do- and results butamine stress MPI. Follow-up was successful in 206 patients; 12 patients were excluded due to early revascularization. The current data are based on the remaining 194 patients. Follow-up end points were all-cause mortality, cardiac mortality, and nonfatal myocardial infarction. The Kap lan-Meier survival curves were constructed, and univariable and multivariable analyses were performed to identify predictors of long-term outcome. During a mean follow-up of 8.1 ± 5.9 years, 134 (69%) patients died of which 68 (35%) died due to cardiac causes. Nonfatal myocardial infarction occurred in 24 patients (12%), and late (> 60 days) coronary revascularization was performed in 61 (13%) patients. Survival analysis showed that MPI provided optimal risk stratification up to 4 years after testing. After that period, the outcome was comparable in patients with normal and abnormal MPI. Multivariable analyses showed that MPI provided incremental prognostic value up to 4 years after testing. Conclusion In high-risk patients with diabetes mellitus, dobutamine MPI provides incremental prognostic information in addition to clinical data for a 4-year period after testing.
- Subjects
CONFIDENCE intervals; DIABETES; PEOPLE with diabetes; EXERCISE tests; INTERVIEWING; LONGITUDINAL method; RESEARCH methodology; MULTIVARIATE analysis; PERFUSION; PROBABILITY theory; RADIONUCLIDE imaging; SURVIVAL analysis (Biometry); POSITRON emission tomography; ACQUISITION of data; PROPORTIONAL hazards models; LOG-rank test
- Publication
European Heart Journal - Cardiovascular Imaging, 2016, Vol 17, Issue 8, p871
- ISSN
2047-2404
- Publication type
Article
- DOI
10.1093/ehjci/jev351