Routine Perioperative Dipyridamole 2O1TI Imaging in Diabetic Patients Undergoing Vascular Surgery: Is it necessary?
Routine Perioperative Dipyridamole 2O1TI Imaging in Diabetic Patients Undergoing Vascular Surgery: Is it necessary?
复制标题
接受血管手术的糖尿病患者围手术期常规双嘧达莫 2O1TI 成像：有必要吗？
作者：
S. Zarich;Mylan C. Cohen;Steven E. Lane;M. Mittleman;R. Nesto;Thomas Hill;David Campbell;S. Lewis
目的探讨潘生丁铊检测在糖尿病血管手术中的应用价值。研究设计与方法93例糖尿病患者行外周血管手术，术前行潘生丁201Tl心肌显像。评估了临床变量和铊变量在预测心血管并发症中的作用。结果确定两组患者：A组(36例)无心脏病临床证据，B组(57例)有心脏病临床证据。A组36例患者中有21例(58%)Tl扫描异常，而B组57例患者中53例(93%)异常(P<；0.0001)。与B组灌注缺损者相比，A组灌注缺损者的单次扫描缺损率明显减少(2.7±1.5比3.6±1.9，P=0.05)。A组围手术期心脏并发症发生率为16%(95%CI 7~28%)，B组围手术期心脏并发症发生率为9/57(P=0.01)。对于整个研究人群，并发症发生率为10%。结论无冠状动脉病变临床标志物的糖尿病患者发生血管手术后不良心脏事件的风险较低。在糖尿病患者的这一亚组中，术前心肌灌注成像对心血管风险评估的帮助很小。
OBJECTIVE To assess the utility of dipyridamole thallium testing in symptomatic and asymptomatic patients with diabetes undergoing vascular surgery. RESEARCH DESIGN AND METHODS Dipyridamole 201Tl myocardial scmtigraphy was performed preoperatively in 93 consecutive patients with diabetes undergoing peripheral vascular procedures. The utility of clinical and thallium variables in predicting cardiovascular complications was assessed. RESULTS Two groups of patients were identified: group A (36 patients) without clinical evidence of cardiac disease and group B (57 patients) with clinical evidence of cardiac disease. Dipyridamole thallium scans were abnormal in 21 of 36 (58%) of group A patients compared with 53 of 57 (93%) of group B patients (P < 0.0001). Compared with group B patients with perfusion defects, group A patients with perfusion abnormalities tended to have fewer defects per scan (2.7 ± 1.5 vs. 3.6 ± 1.9, P = 0.05). No perioperative cardiac complications occurred in group A patients while perioperative cardiac complications occurred in 9 of 57 (16%, 95% CI 7-28%) group B patients (P = 0.01). For the entire study population, the complication rate was 10%. CONCLUSIONS Diabetic individuals without clinical markers for coronary artery disease appear to be at low risk for adverse postoperative cardiac events after vascular surgery. Preoperative myocardial perfusion imaging may add little to cardiovascular risk assessment in this subgroup of patients with diabetes.
影响因子：
2.8
作者：
VIGORITA, VJ;MOORE, GW;HUTCHINS, GM
通讯作者：
HUTCHINS, GM