Vnitr Lek 2006, 52(2):119-123

The meaning of the combination of fibrinogen, micro/macroalbuminuria and atheromatosis in the carotic bloodstream for the evaluation of the abnormal finding of the stress myocardial SPECT in the asymptomatic 2nd type diabetic patients

V. Zamrazil jr^*, S. Pálová, D. Holá

Interní klinika 2. lékařské fakulty UK a FN Motol, Praha, přednosta doc. MUDr. Milan Kvapil, CSc.

Objectives:
Stress perfusion myocardial scintigraphy (SPECT) is useful in silent ischemia detection in the group of the asymptomatic type 2. diabetic patients. In our paper we present the combinations of the parameters predictive for stress myocardial SPECT result.

Methods:
We selected parameters (fibrinogen, micro/macroalbuminuria, ateroma in carotid artery bed) that were significantly associated with stress myocardial SPECT result. We analyzed the combinations of these parameters change and evaluated their significance for stress myocardial SPECT result prediction.

Results:
We evaluated 121 type 2. diabetic patients without patological ECG changes and with normal left ventricle ejection fraction. Thirty one (26 %) had abnormal and 90 (74 %) equivocal or normal stress myocardial SPECT result. The combination of ateroma presence in carotid bed and fibrinogen in upper tertile was found in 20 patients. Fifteen of them (75 %) had the abnormal SPECT result. The combinations of the ateroma absence, negative micro/macroalbuminuria and fibrinogen in the middle or lower tertile were present almost in the half of all the examined diabetic patients. Such combinations were connected with normal or equivocal SPECT result in 93-96 % cases.

Conclusion:
Micro/macroalbuminuria, fibrinogen and ateroma in carotid bed found by sonography are significantly associated with stress myocardial SPECT result. Combinations of these parameters changes lead to the futher stratification that enables the rationale approach in the stress examination indication.

Keywords: type 2 diabetes mellitus; fibrinogen; microalbuminuria; carotis artery sonography; coronary artery disease prediction

Received: October 19, 2005; Accepted: November 21, 2005; Published: February 1, 2006  Show citation