Diagnóstico de isquemia miocárdica silente en diabéticos tipo 2 mediante electrocardiograma, ergometría y Gated-SPECT

Para determinar la relacion entre los factores de riesgos ateroscleroticos y la isquemica miocardica silente fueron estudiados 31 pacientes diabeticos tipo 2 asintomaticos con examenes de laboratorio, electrocardiograma, ergometria, Gated-SPECT y coronariografia. Los pacientes fueron clasificados en dos grupos: SPECT positivo y SPECT negativo. Se realizaron pruebas de asociacion para cada variable y se construyeron curvas ROC para identificar marcadores de riesgo. En el 35,5 por ciento de los pacientes se detecto isquemia miocardica silente con una buena correlacion angiografica. Se evidencio asociacion significativa entre SPECT positivo y los factores de riesgo ateroscleroticos: valores bajos de HDLc, antecedentes patologicos familiares de cardiopatia isquemica y enfermedad vascular periferica. Los modelos de regresion logistica concluyeron que valores bajos de HDLc unidos a antecedentes patologicos familiares de cardiopatia isquemica podrian ser fuertes predictores de isquemia miocardica silente en diabeticos tipo 2 asintomaticos. 31 aymptomatic type 2 diabetic patients were studied by lab tests, electrocardiogram, ergometry, Gated-SPECT and coronariography to determine the relation between the atherosclerotic risk factors and the silent myocardial ischemia. Patients were classified into two groups: positive SPECT and negative SPECT. Association tests were made for each variable and ROC curves were constructed to identify risk markers. In 35,5 percent of the patients silent myocardial ischemia was detected with a good angiographic correlation. A siginificant association was evidenced between positive SPECT and the atherosclerotic risk factors, namely, low values of HDLc, family pathological history of ischemic heart disease and peripheral vascular disease. The logistic regression models showed that low values of HDLc together with family pathological history of ischemic heart disease may be strong predictors of silent myocardial ischemia in asymptomatic type 2 diabetic patients.