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Item
#3
Mortality
Higher in Diabetic Women Than Diabetic Men
Diabetic
women and patients with insulin-dependent diabetes mellitus (IDDM)
are at greater risk of cardiac death than other diabetic patients.
Furthermore,
there appears to be no gender bias in identifying those at high
risk of cardiac mortality when testing is performed using
adenosine myocardial perfusion single-photon emission computed
tomography (MPS).
Dr.
Daniel S. Berman, of Cedars-Sinai Medical Center in Los Angeles,
and colleagues analyzed prospectively collected data for 2656
women and 2677 men with suspected or known coronary artery disease
(CAD). The subjects were followed for more than a year after
undergoing rest thallium-201/adenosine technetium-99m sestamibi
MPS.
During
a mean follow-up of 27 months, cardiac death rate was 4.4% in
women and 6.1% in men. Multivariate analysis showed that
nondiabetic men and women had similar risk, 1.6% for those with
mild abnormalities and 6.1% for severe abnormalities. However,
among those patients with severe abnormalities, women with
diabetes were at greater risk than diabetic men, at 8.5% and 6.0%,
respectively.
For
any degree of summed stress score abnormality, patients with
diabetes had a higher event rate than nondiabetics, and those with
IDDM were at higher risk than those with NIDDM, the report
indicates.
This
study is the first to show an increased risk of death for any MPS
scan result in insulin dependent patients and that female diabetes
are a higher risk than diabetic men in each category of scan
finding.
Dr.
Berman stated that "Our findings in both diabetics and
non-diabetics show that adenosine MPS can be very effective in
establishing mortality risk in patients who are unable to exercise
and in helping determine who needs the most aggressive
therapy," he added.
J
Am Coll Cardiol 2003;41:1125-1133.
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