What is it about?
A retrospective study of 1074 patients undergoing myocardial perfusion imaging found that while anginal symptoms predicted abnormal scan findings in the general population, they did not do so in diabetic patients specifically. Diabetics were more likely to have perfusion defects and ventricular dysfunction regardless of symptoms.
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Why is it important?
This study highlights limitations in using a symptom-based approach for cardiac workup in diabetic patients, who often have neuropathy masking ischemic symptoms. It suggests more liberal use of functional testing in diabetics due to their higher pretest probability of abnormalities.
Perspectives
I found this study intriguing in how it demonstrated the typical predictive value of anginal symptoms breaking down in the diabetic population. It calls into question our reliance on clinical symptoms over testing for this high risk group. Given the rising prevalence of diabetes, we need clear diagnostic algorithms that account for the unique presentation and comorbidities of these patients. This study provides evidence to justify expanding our utilization of myocardial perfusion imaging and other modalities in diabetic workups, though cost-effectiveness data would further support changing guidelines.
Thomas F Heston MD
University of Washington
Read the Original
This page is a summary of: Anginal symptoms are not predictive of myocardial perfusion or function in diabetics, Journal of Nuclear Cardiology, July 2005, Springer Science + Business Media,
DOI: 10.1016/j.nuclcard.2005.06.028.
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