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Prognostic value of normal stress myocardial perfusion imaging in diabetic patients: A meta-analysis

  • CME Article
  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Background

The prognostic value of normal stress myocardial perfusion single-photon emission computed tomography (MPS) in patients with diabetes has only been evaluated in single-center studies of relatively limited sample size. We performed a meta-analysis of published studies, including diabetic patients with known or suspected coronary artery disease (CAD), to assess the predictive value for adverse cardiac ischemic events of normal stress MPS.

Methods and Results

Studies published between January 1990 and December 2013 were identified by database search. We included studies using stress MPS to evaluate diabetic patients with known or suspected CAD and providing data on clinical outcomes of non-fatal myocardial infarction or cardiac death with a follow-up time ≥12 months. A total of 14 studies were finally included, recruiting 13,493 patients. The negative predictive value (NPV) for non-fatal myocardial infarction and cardiac death of normal MPS was 94.92% (95% confidence interval 93.67-96.05), during a weighted mean follow-up of 36.24 months, resulting in estimated event rate after a negative test equal to 5.08% (95% confidence interval 3.95-6.33). The corresponding annualized event rate after a negative test was 1.60% (95% confidence interval 1.21-2.04).

Conclusions

Stress MPS has a high NPV for adverse cardiac events in diabetic patients with known or suspected CAD leading to define a “relatively low-risk” patients category.

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Disclosures

The authors have indicated that they have no financial conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Biostructure and Bioimaging, National Council of Research, Naples, Italy

    Wanda Acampa MD, PhD, Stefania Daniele BSc & Giorgio Punzo PhD

  2. SDN Foundation, Institute of Diagnostic and Nuclear Development, Naples, Italy

    Valeria Cantoni MS

  3. Department of Advanced Biomedical Sciences, University Federico II, Via Pansini 5, 80131, Naples, Italy

    Roberta Green MS, Francesca Maio MD, Carmela Nappi MD, Valeria Gaudieri MD & Alberto Cuocolo MD

  4. Department of Translational Medicine, University Federico II, Naples, Italy

    Mario Petretta MD

Authors
  1. Wanda Acampa MD, PhD
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  2. Valeria Cantoni MS
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  3. Roberta Green MS
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  4. Francesca Maio MD
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  5. Stefania Daniele BSc
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  7. Valeria Gaudieri MD
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  8. Giorgio Punzo PhD
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  9. Mario Petretta MD
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  10. Alberto Cuocolo MD
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Corresponding author

Correspondence to Alberto Cuocolo MD.

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Acampa, W., Cantoni, V., Green, R. et al. Prognostic value of normal stress myocardial perfusion imaging in diabetic patients: A meta-analysis. J. Nucl. Cardiol. 21, 893–902 (2014). https://doi.org/10.1007/s12350-014-9918-0

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  • DOI: https://doi.org/10.1007/s12350-014-9918-0

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