Prognostic relevance of symptoms versus objective evidence of coronary artery disease in diabetic patients.

Abstract:

AIM:Little is known about the prognostic significance of silent versus symptomatic coronary artery disease (CAD) in diabetic patients. We therefore assessed the incidence of scintigraphic evidence of CAD in diabetic patients without known CAD and the impact of symptoms and scintigraphic findings on prognosis. METHODS AND RESULTS:A consecutive series of 1737 diabetic patients without known CAD underwent dual-isotope myocardial perfusion SPECT (MPS) and 1430 were followed-up for a median of 2 (1-8.5) years. Critical events were defined as myocardial infarction or cardiac death. Objective evidence of CAD was found in 39% of 826 asymptomatic diabetic patients, in 51% of 151 diabetic patients with shortness of breath (SOB), and in 44% of 760 diabetic patients with angina. During follow-up, 98 critical events occurred. Annual critical event rates were 2.2% in asymptomatic, 3.2% in angina, and 7.7% in diabetic patients with shortness of breath ( p < 0.001 versus other groups). With MPS evidence of CAD, critical event rates increased to 3.4% (asymptomatic), 5.6% (angina), and 13.2% (SOB) ( p

journal_name

Eur Heart J

journal_title

European heart journal

authors

Zellweger MJ,Hachamovitch R,Kang X,Hayes SW,Friedman JD,Germano G,Pfisterer ME,Berman DS

doi

10.1016/j.ehj.2004.02.013

subject

Has Abstract

pub_date

2004-04-01 00:00:00

pages

543-50

issue

7

eissn

0195-668X

issn

1522-9645

pii

S0195668X04001198

journal_volume

25

pub_type

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