Predictive value of quantitative dipyridamole-thallium scintigraphy in assessing cardiovascular risk after vascular surgery in diabetes mellitus

Journal Article · Thu Nov 30 23:00:00 EST 1989 · American Journal of Cardiology; (USA)

DOI:https://doi.org/10.1016/0002-9149(89)90567-5· OSTI ID:5082782

Lane, S E; Lewis, S M; Pippin, J J; Kosinski, E J; Campbell, D; Nesto, R W; Hill, T ^[1]

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1. New England Deaconess Hospital, Boston, MA (USA)

Cardiac complications represent a major risk to patients undergoing vascular surgery. Diabetic patients may be particularly prone to such complications due to the high incidence of concomitant coronary artery disease, the severity of which may be clinically unrecognized. Attempts to stratify groups by clinical criteria have been useful but lack the predictive value of currently used noninvasive techniques such as dipyridamole-thallium scintigraphy. One hundred one diabetic patients were evaluated with dipyridamole-thallium scintigraphy before undergoing vascular surgery. The incidence of thallium abnormalities was high (80%) and did not correlate with clinical markers of coronary disease. Even in a subgroup of patients with no overt clinical evidence of underlying heart disease, thallium abnormalities were present in 59%. Cardiovascular complications, however, occurred in only 11% of all patients. Statistically significant prediction of risk was not achieved with simple assessment of thallium results as normal or abnormal. Quantification of total number of reversible defects, as well as assessment of ischemia in the distribution of the left anterior descending coronary artery was required for optimum predictive accuracy. The prevalence of dipyridamole-thallium abnormalities in a diabetic population is much higher than that reported in nondiabetic patients and cannot be predicted by usual clinical indicators of heart disease. In addition, cardiovascular risk of vascular surgery can be optimally assessed by quantitative analysis of dipyridamole-thallium scintigraphy and identification of high- and low-risk subgroups.

• OSTI ID: 5082782
• Journal Information: American Journal of Cardiology; (USA), Journal Name: American Journal of Cardiology; (USA) Vol. 64:19; ISSN 0002-9149; ISSN AJCDA
• Country of Publication: United States
• Language: English

Related Subjects

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59 BASIC BIOLOGICAL SCIENCES
62 RADIOLOGY AND NUCLEAR MEDICINE
BODY
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DIABETES MELLITUS
DIAGNOSIS
DIAGNOSTIC TECHNIQUES
DIAGRAMS
DISEASES
ELECTROCARDIOGRAMS
ENDOCRINE DISEASES
HEART
ISOTOPES
MEDICINE
METABOLIC DISEASES
ORGANS
PATIENTS
RADIOISOTOPE SCANNING
RISK ASSESSMENT
SCINTISCANNING
SURGERY
THALLIUM ISOTOPES
VASCULAR DISEASES