Cardiometabolic & kidneyCohort study
Prevalence and Prognostic Importance of Abnormal Positron Emission Tomography Among Asymptomatic Patients With Diabetes Mellitus
- Retrospective cohort study
- consecutive patients
Authors' conclusion
In both symptomatic and asymptomatic patients with DM, impairment in MBFR is common and associated with greater mortality risk.
Study context
- Population
- Patients with diabetes mellitus (DM) without known coronary artery disease (CAD) or cardiomyopathy undergoing rubidium-82 rest/stress positron emission tomography (PET) myocardial perfusion imaging (MPI), 2010–2016
- Participants
- 2,730 patients
- Exposure
- Asymptomatic vs symptomatic patients with DM
- Asymptomaticn = 647
- Outcome
- Prevalence of ischemia, reduced MBFR and coronary microvascular dysfunction; prognostic association with all-cause mortality
- Follow-up
- Median 3 years
Main finding
As reported in the abstract
Prevalence of abnormal PET among asymptomatic patients
| Group | Ischemia | Reduced myocardial blood flow reserve (MBFR) | Coronary microvascular dysfunction |
|---|---|---|---|
| Asymptomatic | 30.5% (n = 197) | 62.3% (n = 361) | 32.7% (n = 200) |
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| All-cause mortality among asymptomatic patients (adjusted) · median follow-up 3 years — reduced MBFR vs Symptomatic | HR per 0.1 unit decrease in MBFR 1.08 (95% CI 1.03–1.12) | P = 0.001 | |
| All-cause mortality among asymptomatic patients (adjusted) · median follow-up 3 years — reduced ejection fraction vs Symptomatic | HR per 5% decrease 1.10 (95% CI 1.01–1.18) | P = 0.02 | |
| 0.512Ratio (log scale) |
All-cause mortality among asymptomatic patients (adjusted) · median follow-up 3 years
- Ischemia not independently prognostic of mortality
- Comparable to DM patients with symptoms
Predictors of reduced MBFR among asymptomatic patients
- Insulin use and older age were significant predictors
Original publication
Prevalence and Prognostic Importance of Abnormal Positron Emission Tomography Among Asymptomatic Patients With Diabetes Mellitus. JACC Cardiovasc Imaging. Published 18 October 2023. doi:10.1016/j.jcmg.2023.08.010
Summarised from the published abstract; every number is checked against it