Determinants Of Myocardial Perfusion Reserve Assessed By Dynamic Stress 201tl/Rest99mtc-Tetrofosmin Single Photon Emission Computed Tomography In Patients With Diabetes Mellitus And Stable Coronary Artery Disease

1604 Objectives: Quantification of myocardial perfusion reserve (MPR) provides predictive information on cardiovascular outcome. We aimed to identify determinants of myocardial flow reserve in patients with type 2 diabetes mellitus and stable coronary artery disease.\n Methods: We conducted a prospective study to enroll consecutive patients who were aged 19 years or older, and had type 2 diabetes mellitus and stable coronary artery disease. All patients underwent dynamic stress 201Tl/rest 99mTc-tetrofosmin single photon emission computed tomography (SPECT) using a dedicated multiple pinhole camera with cadmium-zinc-telluride detectors.\n Results: Between July 2017 and September 2019, we included 277 patients for analysis. There were 236 men, and 41 women. The median age was 65 [interquartile range (IQR), 59-71]. The median global MPR was 2.4 [1.9-3.0]. Characteristics of patients that showed a significantly lower MPR were advanced age of more than 70 years (n=74, 2.2 [1.8-2.6] vs. 2.4 [2.0-3.0], P=0.034), smoking history (n=63, 2.2 [1.8-2.4] vs. 2.5 [2.0-3.1], P=0.0004), hyperlipidemia (n=85, 2.2 [1.9-2.6] vs. 2.5 [1.9-3.1], P=0.021), hypertension (n=204, 2.3 [1.9-2.8] vs. 2.6 [2.0-3.2], P=0.013), and abnormal summed stress score of myocardial perfusion scan (n=136, 2.2 [1.7-2.7] vs. 2.5 [2.1-3.1], P 0.1). Multivariate linear regression analysis showed that age of more than 70 years (P=0.0098), smoking history (P=0.0012), hypertension (P=0.013), and abnormal summed stress score of myocardial perfusion scan (P=0.0011) were independent determinants of MPR.\n Conclusions: Advanced age and cardiovascular risk factors are determinants of MPR assessed by dynamic stress 201Tl/rest 99mTc-tetrofosmin SPECT in patients with type 2 diabetes and stable coronary artery disease.