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OtherClinical Investigations

Association of Ischemia on Stress99mTc-Tetrofosmin Myocardial Perfusion Imaging with All-Cause Mortality in Patients with Diabetes Mellitus

Abdou Elhendy, Aukje Huurman, Arend F.L. Schinkel, Jeroen J. Bax, Ron T. van Domburg, Roelf Valkema, Elena Biagini and Don Poldermans
Journal of Nuclear Medicine October 2005, 46 (10) 1589-1595;
Abdou Elhendy
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Aukje Huurman
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Arend F.L. Schinkel
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Jeroen J. Bax
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Ron T. van Domburg
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Roelf Valkema
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Elena Biagini
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Don Poldermans
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    FIGURE 1.

    Kaplan–Meier survival curves (total mortality) in diabetic patients with normal perfusion, reversible defects, and fixed defects.

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    TABLE 1

    Clinical, Stress Test, and Scintigraphic Data of Patients Who Survived and Patients Who Died During Follow-Up

    ParameterPatients who died (n = 80)Patients who survived (n = 217)P
    Age (y)64 ± 859 ± 90.001
    Men57 (71)133 (61)0.1
    Previous myocardial infarction31 (39)57 (27)0.01
    Hypertension46 (58)128 (59)NS
    Smoking18 (23)39 (13)0.09
    Hypercholesterolemia35 (44)105 (48)NS
    Symptom
        None30 (38)71 (33)NS
        Heart failure28 (35)42 (19)0.01
        Atypical chest pain26 (33)70 (32)NS
        Angina18 (23)65 (30)NS
    Peripheral vascular disease16 (20)26 (12)0.03
    Peripheral neuropathy12 (15)22 (10)0.08
    Overt nephropathy22 (28)43 (20)0.04
    Previous stroke4 (5)7 (3)NS
    Resting heart rate (beats/min)    81 ± 1880 ± 16NS
    Dobutamine stress test69 (86)160 (74)0.02
    Stress heart rate (beats/min)130 ± 15134 ± 170.08
    Resting systolic blood pressure (mm Hg)146 ± 28145 ± 230.7
    Stress systolic blood pressure (mm Hg)155 ± 33174 ± 340.001
    Stress rate pressure product18,549 ± 4,80022,420 ± 6,0840.001
    ST-segment depression18 (23)41 (19)0.1
    Angina during stress12 (15)54 (25)0.02
    Scan result0.001
        Normal20 (25)98 (45)
        Completely reversible defects10 (13)22 (10)
        Fixed and reversible defects28 (35)43 (20)
        Fixed defect22 (28)54 (25)
        Summed stress score5.2 ± 3    2.8 ± 2.3
    • NS = not significant.

      Values in parentheses are percentages.

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    TABLE 2

    Independent Predictors of Mortality and Cardiac Events in Multivariate Analysis Models

    ParameterHazard ratioConfidence interval
    All-cause mortality
        Age*1.041.02–1.07
        Male sex1.91.2–3.0
        Heart failure1.61.1–2.5
        Peripheral vascular disease1.51.2–2.9
        Stress systolic blood pressure0.920.88–0.96
        Reversible perfusion defects1.91.2–2.6
        Summed stress score*1.31.1–2.1
    Hard cardiac events
        Age*1.051.01–1.08
        Male sex1.81.1–3.1
        Heart failure2.61.5–4.3
        Peripheral vascular disease1.61.1–3.2
        Reversible perfusion defects2.31.4–3.9
        Summed stress score*1.21.1–1.3
    Cardiac death
        Age1.041.01–1.08
        Heart failure2.31.2–4.2
        Reversible perfusion defects2.41.3–4.3
        Summed stress score1.21.1–1.3
    • ↵* Per 1-unit increment.

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Journal of Nuclear Medicine: 46 (10)
Journal of Nuclear Medicine
Vol. 46, Issue 10
October 1, 2005
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Association of Ischemia on Stress99mTc-Tetrofosmin Myocardial Perfusion Imaging with All-Cause Mortality in Patients with Diabetes Mellitus
Abdou Elhendy, Aukje Huurman, Arend F.L. Schinkel, Jeroen J. Bax, Ron T. van Domburg, Roelf Valkema, Elena Biagini, Don Poldermans
Journal of Nuclear Medicine Oct 2005, 46 (10) 1589-1595;

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Association of Ischemia on Stress99mTc-Tetrofosmin Myocardial Perfusion Imaging with All-Cause Mortality in Patients with Diabetes Mellitus
Abdou Elhendy, Aukje Huurman, Arend F.L. Schinkel, Jeroen J. Bax, Ron T. van Domburg, Roelf Valkema, Elena Biagini, Don Poldermans
Journal of Nuclear Medicine Oct 2005, 46 (10) 1589-1595;
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