Cardiovascular events in Japanese asymptomatic patients with type 2 diabetes: a 1-year interim report of a J-ACCESS 2 investigation using myocardial perfusion imaging
Cardiovascular events in Japanese asymptomatic patients with type 2 diabetes: a 1-year interim report of a J-ACCESS 2 investigation using myocardial perfusion imaging
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日本无症状 2 型糖尿病患者的心血管事件：使用心肌灌注成像的 J-ACCESS 2 调查的 1 年中期报告
DOI：
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发表时间：
2009
影响因子：
9.1
通讯作者：
T. Nishimura
中科院分区：
文献类型：
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作者：
K. Nakajima;Y. Yamasaki;H. Kusuoka;T. Izumi;A. Kashiwagi;R. Kawamori;K. Shimamoto;N. Yamada;T. Nishimura
目的糖尿病患者发生心血管事件的风险较高。研究心肌灌注显像在无症状糖尿病患者中的作用，以评估日本人群的短期预后。方法纳入了 506 名年龄≥50 岁、颈动脉最大内膜中层厚度≥1.1 毫米、尿白蛋白排泄≥30 mg/g 肌酐、附加腹部肥胖、低 HDL 胆固醇、高甘油三酯水平和高血压的无症状患者。并进行了长达3年的随访。采用应力休息方案进行门控 SPECT，并通过缺陷评分总和和 QGS 软件进行分析。分析一年的心血管事件。结果17%的患者出现心肌缺血，32%的患者出现缺血和/或疤痕的异常灌注表现。到 1 年随访结束时，发生了 33 起（6.5%）心血管事件，其中包括 6 起全因死亡。总压力评分 (SSS) > 8 的患者死亡或心血管事件的发生率较高。 SSS 0-3、4-8、9-13 和≥14 的无事件生存率分别为 0.96、0.95、0.82 和 0.76。多变量Cox回归分析显示显着变量为SSS、脑血管意外病史和静息心电图异常。结论1年中期总结显示，SPECT异常患者的心血管事件显着较高，尽管硬心脏事件发生率相对较低。对于无症状但潜在高危的糖尿病患者，需要采取针对性的治疗策略。
PurposeDiabetic patients have a high risk for cardiovascular events. The role of myocardial perfusion imaging was investigated in asymptomatic diabetic patients to evaluate short-term prognosis in a Japanese population.MethodsA total of 506 asymptomatic patients ≥50 years of age who had carotid artery maximum intima-media thickness ≥1.1 mm, urinary albumin excretion of ≥30 mg/g creatinine, with additional criteria of abdominal obesity, low HDL cholesterol, high triglyceride level, and hypertension were enrolled and followed up over a 3-year period. Gated SPECT with stress-rest protocol was performed and analyzed by summed defect scores and QGS software. One-year cardiovascular events were analyzed.ResultsMyocardial ischemia was observed in 17% of patients, and abnormal perfusion findings of ischemia and/or scar were observed in 32% of patients. By the end of the 1-year follow-up, 33 (6.5%) cardiovascular events occurred including 6 all-cause deaths. Patients with summed stress score (SSS) >8 had a higher incidence of either death or cardiovascular events. Event-free survival rates for SSS 0–3, 4–8, 9–13, and ≥14 were 0.96, 0.95, 0.82, and 0.76, respectively. Multivariate Cox regression analysis showed that significant variables were SSS, history of cerebrovascular accident, and electrocardiographic abnormality at rest.ConclusionThe 1-year interim summary showed that cardiovascular events were significantly higher in patients with SPECT abnormality, although hard cardiac event rate was relatively low. Targeted treatment strategy is required for asymptomatic but potentially high-risk diabetic patients.
影响因子：
16.2
作者：
Wackers, FJT;Young, LH;Iskandrian, AE
通讯作者：
Iskandrian, AE