Evaluation of Cardiac Events in Diabetic Patients with Inadequate Exercise Test and Normal Myocardial Perfusion Scan Compared to the Control Group

Abstract

Objective: Ischemic heart disease is one of the most important complications of diabetes mellitus. This study aimed to compare the incidence of cardiovascular events in diabetic patients with inadequate exercise testing and normal myocardial perfusion scans with those who had adequate exercise testing and normal scans.

Materials and Methods: This retrospective study was conducted at Shahid Sadoughi Hospital in Yazd, Iran. Medical records of patients referred to the nuclear medicine department were reviewed. Patients were divided into two groups: those with inadequate exercise tests but normal myocardial perfusion scans and those with adequate exercise tests and normal scans. Patients’ contact information was obtained from their medical records, and follow-up was performed by telephone to determine the occurrence of cardiovascular events, including cardiovascular-related death, coronary angiography, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG), myocardial infarction, and hospitalization due to cardiovascular disease. Data were analyzed using SPSS version 20, and statistical analyses were performed using the independent t-test and Chi-square test.

Results: A total of 210 patients were included in the study, of whom 86 (41%) were male. Dyslipidemia was present in 120 patients (57.1%), hypertension in 89 (42.4%), and smoking in 48 (22.9%). Hypertension and smoking were significantly more common in the study group than in the control group. Cardiovascular events occurred in 18 patients (17.1%) in the study group and 10 patients (9.5%) in the control group; however, this difference was not statistically significant (P= 0.10). Although the risk of cardiovascular events in the study group was 1.35 times higher than in the control group, this difference was not statistically significant (P= 0.60).

Conclusion: Although the incidence of cardiovascular events was higher among diabetic patients with inadequate exercise testing and normal myocardial perfusion scans, the difference compared with patients with adequate exercise testing and normal scans was not statistically significant.