Significance of Myocardial Perfusion SPECT (Single-Photon Emission Computed Tomography) Imaging in the Detection of Silent Myocardial Ischemia in Type II Diabetic Patients with Microalbuminuria

Silent Myocardial ischemia is frequent among type II diabetic patients. Objectives: To evaluate the role of microalbuminuria in predicting silent myocardial ischemia in diabetics undergoing myocardial perfusion scintigraphy and identify a sub-group for early myocardial perfusion scintigraphy and precise coronary artery disease treatment. Methods: This prospective study was conducted at the Pakistan Institute of Nuclear Medicine Cancer Hospital, Faisalabad, Pakistan from December 2023 to May 2024. Fifty-four patients were included in the study. All patients were type II diabetics with no previous history of coronary artery disease or angina pectoris. Gated myocardial perfusion scintigraphy was performed in all the subjects. Microalbuminuria was assessed in the morning urine samples of each patient. Results: Silent myocardial ischemia was detected in 26 (48%) of the 54 patients. The incidence of silent ischemia was significantly higher (p<0.05) in diabetic patients with microalbuminuria 22 (58%) as compared to diabetic individuals without microalbuminuria 12 (75%). Microalbuminuria was the independent and significant predictor of silent myocardial ischemia on myocardial perfusion scintigraphy (odds ratio 6.61, 95% CI 1.23 – 35.38; p=0.027). Conclusions: It was concluded that testing for microalbuminuria in asymptomatic type II diabetes patients can improve testing accuracy for detecting silent myocardial ischemia with myocardial perfusion scintigraphy. Myocardial perfusion Single-Photon Emission Computed Tomography scintigraphy (SPECT) is a useful imaging technique for early coronary artery disease detection in individuals with DM.