Background: Given the poor prognosis of CAD among type 2 DM patients, it is essential to have an early accurate diagnosis. MPS with SPECT has been extensively used in CAD detection and is a potent prognostic tool for risk stratification. It's used in screening for CAD among DM population is still under study but with promising result. There is currently no available data for the association of type 2 DM and the presence of myocardial ischemia among Filipino patients using stress MPS, thus this study aims to fill that gap.
Method: This study was a retrospective chart review of randomly selected patients without previous cardiac events in whom MPS using Thallium-201 were performed over a 24-month period. Association of myocardial ischemia was compared using logistic regression analysis based on total summed stress score (SSS) values among type 2 DM and non-diabetic group.
Results: Total of 208 patients who underwent stress or pharmacologic MPS using Thallium-201 were included in the study. The mean age for patients with type 2 DM and those without the disease were 59.1 and 57.2 years, respectively. Majority were male subjects. Abnormal 2D echo result and lower ejection fraction (EF) were significantly present among patients with type 2 DM (p=0.044, 0.0005). Hypertension was more prominent among the list of co-morbidities and was significantly associated with type 2 DM (p = 0.025). The distribution of type 2 DM patients with insignificant, mildly abnormal, and moderate to severely abnormal CAD were 60.6%, 12.5%, and 26.9%, respectively. Moderate to severely abnormal myocardial ischemia (SSS >9) was more prominent among patients with type 2 DM. The presence of CAD was associated with the diabetic group at 66.1%. The odds of having significant CAD among type 2 DM patients is 2.57 higher than their counterpart (95% CI: 1.38-4.78, p = 0.003).
Conclusion: The current study has shown that Filipino type 2 DM patients without previous cardiac events are likely to have significant and more severe scintigraphic evidence of CAD than their non- type 2 DM counterpart.