Myocardial Ischemic Burden and Differences in Prognosis Among Patients With and Without Diabetes

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Patients with and without diabetes who underwent quantification of total perfusion deficit (TPD) on SPECT myocardial perfusion imaging were followed to evaluate the risk of major adverse cardiovascular events (MACE). Patients with diabetes had a significantly higher risk of MACE than patients without diabetes at all levels of TPD >0%. Among patients with diabetes, the risk of MACE was higher in those with minimal TPD compared with those with TPD 0%. The risk of MACE was comparable in patients with diabetes with a TPD of 0.5% and patients without diabetes with a TPD of 8%.

For all levels of TPD, the risk of MACE was higher in patients with diabetes than patients without. Patients with diabetes plus minimal ischemia have the same risk of MACE as patients with significant ischemia without diabetes.