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Myocardial ischemia, carotid, and peripheral arterial disease and their interrelationship in type 2 diabetes patients

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Cardiovascular disease (CVD) is the leading cause of death in type 2 diabetes mellitus (T2DM) patients. We examined the relationship between CVD in different vascular territories.

Methods

T2DM patients without known or suspected CVD (n = 305) referred consecutively to a diabetes clinic for the first time and age-matched nondiabetic reference subjects (n = 40) were screened for myocardial ischemia, carotid, and peripheral arterial disease by means of myocardial perfusion scintigraphy, carotid artery ultrasonography, and peripheral ankle and toe systolic blood pressure measurements.

Results

In the T2DM patients, the prevalence of myocardial ischemia, carotid, and peripheral arterial disease was 30%, 42%, and 15%, respectively, almost three times higher than in the reference subjects (P = 0.007, P = 0.001, and P = 0.09, respectively). T2DM patients with myocardial ischemia, carotid, or peripheral arterial disease had a significantly increased risk of CVD in other vascular territories as well (OR: 1.99, 2.09, and 3.09, respectively). However, 40%, 52%, and 22% of the T2DM patients with myocardial ischemia, carotid, or peripheral arterial disease demonstrated exclusively this particular type of CVD manifestation.

Conclusions

In T2DM patients, signs of CVD in one vascular territory carry a significantly increased risk of CVD in other territories, although many patients only presented one manifestation.

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Acknowledgments

Thanks to the laboratory technicians, nurses, and secretaries: Lone Hansen, Charlotte Olsen, Pia Hedegaard, Irene Knudsen, Stella Hold, Tina Godskesen, Mette Høilund-Carlsen, Janne Milton, Charlotte Anker, Jane Petersen, Helle Arnsted, Karin Koertz, and Bente Wichman. Thanks to Lars Videbæk, MD, PhD, for making it possible to perform the ultrasound scans of the carotid arteries. The study was funded by the Danish Cardiovascular Research Academy (DaCRA), The Danish Diabetes Association, The Danish Heart Foundation, Overlægerådet of Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Sehested Hansen’s Foundation, Family Hede Nielsen’s Foundation, and Bernhard and wife Marie Klein’s Grant.

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Authors and Affiliations

  1. Department of Endocrinology, Odense University Hospital, Kløvervænget 6, 5th Floor, 5000, Odense C, Denmark

    Mikael K. Poulsen MD, Jan Erik Henriksen MD, PhD & Henning Beck-Nielsen MD, DMSc

  2. Department of Nuclear Medicine, Odense University Hospital, Odense C, Denmark

    Allan Johansen MD, DMSc & Poul Flemming Høilund-Carlsen MD, DMSc

  3. Department of Cardiology, Odense University Hospital, Odense C, Denmark

    Jordi Dahl MD & Torben Haghfelt MD, DMSc

  4. Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark

    Jacob E. Møller MD, PhD, DMSc

  5. Department of Statistics, University of Southern Denmark, Odense M, Denmark

    Oke Gerke PhD & Werner Vach PhD

Authors
  1. Mikael K. Poulsen MD
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  2. Jan Erik Henriksen MD, PhD
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  3. Jordi Dahl MD
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  4. Allan Johansen MD, DMSc
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  8. Torben Haghfelt MD, DMSc
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  9. Henning Beck-Nielsen MD, DMSc
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  10. Poul Flemming Høilund-Carlsen MD, DMSc
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Corresponding author

Correspondence to Mikael K. Poulsen MD.

Additional information

The trial has been registered at www.clinicaltrial.gov with Identifier: NCT00298844.

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Poulsen, M.K., Henriksen, J.E., Dahl, J. et al. Myocardial ischemia, carotid, and peripheral arterial disease and their interrelationship in type 2 diabetes patients. J. Nucl. Cardiol. 16, 878–887 (2009). https://doi.org/10.1007/s12350-009-9118-5

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  • DOI: https://doi.org/10.1007/s12350-009-9118-5

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