Prognostic Value of Normal Stress Myocardial Perfusion Imaging and Ventricular Function in Japanese Asymptomatic Patients With Type 2 Diabetes - A Study Based on the J-ACCESS-2 Database

Background: This study was designed to determine the clinical risk for hard events after normal single-photon emission computed tomography (SPECT) and to identify the predictors of increased risk in asymptomatic patients with diabetes mellitus, based on a Japanese Assessment of Cardiac Events and Survival Studies by quantitative gated SPECT (J-ACCESS)-2 study Methods and Results: A total of 513 consecutive asymptomatic patients who underwent stress Tc-99m-tetrofosmin SPECT in Japan were included in this study Based on SPECT image and OGS data, 319 had a summed stress score a summed difference score <2 and normal cardiac function (end-systolic volume <= 60 ml, males, <= 40 ml, females, left ventricular ejection fraction >= 49%. males. >= 50%, females) Myocardial perfusion was normal in 62% of this study population During a 3-year follow-up, there were a total of 8 cardiac major events (2 5%). 2 cases of sudden death, 5 of acute coronary syndrome, and 1 of hospitalization because of congestive heart failure The annual major event rate was 0 8%. Subjects undergoing coronary angiography had significantly more major events than those who did not among normal SPECT subjects (P=0 01) Kaplan-Meier analysis showed that the cardiac major events rate was very low, and subjects with normal SPECT can be considered as low risk among asymptomatic patients with diabetes Conclusions: An excellent prognosis was associated with a normal SPECT in asymptomatic patients with diabetes, so these patients can be exempted from further invasive procedure (Circ J 2010, 74: 1916-1921)