Results
Of 63 patients, 42 were females (67%) and 21 males (33%), with a mean age of 61.33 ± 6.98 years (range: 42-78). The mean ± SD duration of diabetes was 7.97 ± 4.86 years. Baseline characteristics of participants are presented in Tables 1 & 2.54 patients underwent stress with Dipyridamole,2 with Dobutamine and 7 with exercise.
According to the obtained values of MPI (true SSS> 4, without attenuation artifacts), CAD was detected in 26 (41.3%) patients. Presence of CAD was significantly associated with male gender, smoking and EF (P-values; 0.019, 0.046, 0.033, respectively). While hypertension and dyslipidemia were more common in CAD patients compared to those without CAD, no statistically significant association was noted (P-value > 0.05) (Table 3).
Moreover, patients were divided into five groups based on the duration of diabetes. Kruskal Wallis analysis revealed a significant correlation between the duration of diabetes, especially when more than 15 years, and the probability of CAD, based on SSS, SDS especially in LAD territory (P-value = 0.048) (Figures 1). Besides, requiring Insulin therapy was significantly more prevalent in diabetic patients with CAD compared to those without CAD (P-value = 0.042). (Figure 2)
Mean EDV and ESV were higher in CAD patients compared to diabetic patients without CAD (68.52 ± 3.41 and 29.35 ± 2.14 mL versus 52.72 ± 2.23 and 18.52 ± 1.47 mL). However, the difference was not statistically significant (P-value > 0.05).
According to multivariate logistic analysis, smoking had a significant association with SDS, RCA territory involvement and RV visualization. In addition, duration of DM was significantly associated with higher SSS and SRS, presence of TID, and RCA/LAD territory involvement. Smoking, male gender and diabetes duration were the strongest independent predictors of abnormal MPI results.
Univariant linear regression analysis showed an association between SSS, SRS, LAD/RCA territories involvement and TID with the duration of diabetes. SRS, RCA territory involvement and EF were also independently associated with hyperlipidemia. LAD territory involvement was associated with insulin therapy, HTN, and RV visualization.TID was associated with neuropathy and peripheral arterial disease (PAD). SDS was associated with B-blocker therapy.