Page 111 - Petelin, Ana, Nejc Šarabon, Boštjan Žvanut, eds. 2017. Zdravje delovno aktivne populacije ▪︎ Health of the Working-Age Population. Proceedings. Koper: Založba Univerze na Primorskem/University of Primorska Press
P. 111
nts with T2DM have SMI. More importantly, 13.7% of them have markedly prevalence of silent myocardial ischemia in working-age patients 109
abnormal (moderate-to-severe) myocardial perfusion abnormalities. This jus-
tifies screening for SMI by non-invasive and cost-effective technique such as
SPECT MPI in subpopulation of T2DM patients of the working-age. LV func-
tion testing may have an important role in the SMI risk assessment because of
the association shown in the present study between LVEF drop ≥5%, NT-proB-
NP levels detected in stress and perfusion defects occurring. The presented da-
ta address only the prevalence, severity, and possible predictors of SMI at the
time of enrolment into the study and suggest that advanced intervention pro-
cedures including “aggressive” drug management should be implemented to
reduce the risk of cardiac events in forthcoming future. Follow-up evaluation
should allow to define the relationship between abnormal perfusion imaging
and the prevalence of cardiac events in asymptomatic T2DM patients of work-
ing-age and to evaluate the effectiveness of “aggressive” preventive strategies.
Acknowledgment
This study was supported in part by a grant from KEGA (Cultural and Edu-
cational Granting Agency) 066PU-4/2016, Ministry of Education, Science, Re-
search and Sports of the SR. The research was designed, conducted, analysed,
and interpreted by the authors entirely independently of the funding source.
References
ALEGRIA-BARRERO, A., 2014. New insights regarding management of di-
abetes. An article from the E-journal of the ESC Council for Cardiolo-
gy Practice, vol. 12, no. 11. Available from: https://www.escardio.org/
Journals/E-Journal-of-Cardiology-Practice/Volume-12/New-insights-re-
garding-management-of-diabetes
COSSON, E., ATTALI, J.R. and VALENSI, P., 2005. Markers for silent myo-
cardial ischemia in diabetes. Are they helpful? Diabetes Metab., vol. 31,
no. 2, pp.205-213.
DE KEYZER, E., KERKHOVE, D., VAN CAMP, G., DE SUTTER, J., ACH-
TERGAEL, W., KEYMEULEN, B. and WEYTJENS, C., 2011. Screening
for silent myocardial ischaemia in patients with type 2 diabetes mellitus:
a quest to improve selection of the target screening population. Acta Car-
diol., vol. 66, no. 6, pp. 715-720.
FAGLIA, E., FAVALES, F., CALIA, P., PALEARI, F., SEGALINI, G., GAMBA,
P.L., ROCCA, A., MUSACCHIO, N., MASTROPASQUA, A., TESTORI,
G., et al., 2002. Milan Study on Atherosclerosis and Diabetes (Mi SAD).
Cardiac events in 735 type 2 diabetic patients who underwent screening
for unknown asymptomatic coronary heart disease: 5-year follow-up re-
port from the Milan Study on Atherosclerosis and Diabetes (MiSAD). Di-
abetes Care, vol. 25, no. 11, pp. 2032-2036.
abnormal (moderate-to-severe) myocardial perfusion abnormalities. This jus-
tifies screening for SMI by non-invasive and cost-effective technique such as
SPECT MPI in subpopulation of T2DM patients of the working-age. LV func-
tion testing may have an important role in the SMI risk assessment because of
the association shown in the present study between LVEF drop ≥5%, NT-proB-
NP levels detected in stress and perfusion defects occurring. The presented da-
ta address only the prevalence, severity, and possible predictors of SMI at the
time of enrolment into the study and suggest that advanced intervention pro-
cedures including “aggressive” drug management should be implemented to
reduce the risk of cardiac events in forthcoming future. Follow-up evaluation
should allow to define the relationship between abnormal perfusion imaging
and the prevalence of cardiac events in asymptomatic T2DM patients of work-
ing-age and to evaluate the effectiveness of “aggressive” preventive strategies.
Acknowledgment
This study was supported in part by a grant from KEGA (Cultural and Edu-
cational Granting Agency) 066PU-4/2016, Ministry of Education, Science, Re-
search and Sports of the SR. The research was designed, conducted, analysed,
and interpreted by the authors entirely independently of the funding source.
References
ALEGRIA-BARRERO, A., 2014. New insights regarding management of di-
abetes. An article from the E-journal of the ESC Council for Cardiolo-
gy Practice, vol. 12, no. 11. Available from: https://www.escardio.org/
Journals/E-Journal-of-Cardiology-Practice/Volume-12/New-insights-re-
garding-management-of-diabetes
COSSON, E., ATTALI, J.R. and VALENSI, P., 2005. Markers for silent myo-
cardial ischemia in diabetes. Are they helpful? Diabetes Metab., vol. 31,
no. 2, pp.205-213.
DE KEYZER, E., KERKHOVE, D., VAN CAMP, G., DE SUTTER, J., ACH-
TERGAEL, W., KEYMEULEN, B. and WEYTJENS, C., 2011. Screening
for silent myocardial ischaemia in patients with type 2 diabetes mellitus:
a quest to improve selection of the target screening population. Acta Car-
diol., vol. 66, no. 6, pp. 715-720.
FAGLIA, E., FAVALES, F., CALIA, P., PALEARI, F., SEGALINI, G., GAMBA,
P.L., ROCCA, A., MUSACCHIO, N., MASTROPASQUA, A., TESTORI,
G., et al., 2002. Milan Study on Atherosclerosis and Diabetes (Mi SAD).
Cardiac events in 735 type 2 diabetic patients who underwent screening
for unknown asymptomatic coronary heart disease: 5-year follow-up re-
port from the Milan Study on Atherosclerosis and Diabetes (MiSAD). Di-
abetes Care, vol. 25, no. 11, pp. 2032-2036.
