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Updated: May 20, 2026
In Vivo Quantitative Assessment of Myocardial Structure, Function, Perfusion and Viability Using Cardiac Micro-computed Tomography
Published on: February 16, 2016
The relationship between glycosylated hemoglobin and myocardial perfusion imaging
Nicole M Lynn Fillipon1, Danai Kitkungvan, Sourbha S Dani
1Department of Medicine, Saint Vincent Hospital, Worcester, Massachusetts, USA. nml121180@yahoo.com
Insights
Poorly controlled diabetes, indicated by high hemoglobin A1c (HgbA1C), is linked to abnormal myocardial perfusion imaging (MPI) and coronary artery disease (CAD). This highlights the need for strict glycemic control to prevent cardiovascular complications in diabetic patients.
Area of Science:
- Cardiology
- Diabetology
- Nuclear Medicine
Background:
- The link between long-term glycemic control and myocardial perfusion imaging (MPI) abnormalities in diabetic patients remains understudied.
- Diabetic patients face a higher risk of cardiovascular complications.
Purpose of the Study:
- To investigate the association between glycosylated hemoglobin (HgbA1C) levels and MPI abnormalities in diabetic patients.
- To compare MPI findings in diabetic patients with varying glycemic control against non-diabetic individuals.
Main Methods:
- Retrospective analysis of 1037 patients undergoing MPI.
- Evaluation of electronic medical records for demographics and medical history.
- Coronary angiography data was used to corroborate MPI findings.
Main Results:
- Diabetic patients exhibited a higher risk of abnormal MPI (ischemia, infarction) compared to non-diabetic patients (RR=1.77).
- Suboptimal (HgbA1C ≥ 7%) and poor (HgbA1C ≥ 8%) glycemic control significantly increased the risk of abnormal MPI (RR=1.78 and 2.17, respectively).
- Diabetic patients had a higher prevalence of coronary artery disease (CAD) (66%) compared to non-diabetic patients (53%).
Conclusions:
- Poor long-term glycemic control in diabetic patients is associated with a significantly higher risk of abnormal MPI and CAD.
- Strict glycemic control is crucial for mitigating cardiovascular complications in diabetes mellitus (DM).
- Aggressive risk factor modification is essential to minimize vascular complications in diabetic individuals.
Background:
The relationship between long-term glucose control (measured by glycosylated hemoglobin [HgbA1C]) and myocardial perfusion imaging (MPI) abnormalities in symptomatic diabetic patients has not been studied.
Hypothesis:
We hypothesized that diabetic patients with poorly controlled HgbA1C would have more abnormal MPI compared to both patients without diabetes and diabetic patients with tighter glycemic control.
Methods:
This was a retrospective evaluation of 1037 consecutive patients referred for MPI. All patients completed a 1-day MPI protocol. The electronic medical records were accessed for demographics and relevant medical history.
Results:
Diabetic patients had a higher risk of abnormal MPI (including ischemia, infarction, and mixed ischemia/infarction) compared to nondiabetic patients (relative risk [RR] = 1.77). The populations with suboptimal (HgbA1C ≥ 7%) and poor (HgbA1C ≥ 8%) glycemic control had significantly higher risk of abnormal MPI (RR = 1.78 and 2.17, respectively) compared to nondiabetic patients. Coronary angiography supported the MPI results; 66% of diabetic patients had coronary artery disease (CAD), which was higher than the 53% of patients without diabetes found to have CAD.
Conclusions:
The importance of strict glycemic control to reduce cardiovascular complications in diabetic patients is well known. Our study shows a significantly higher risk of abnormal MPI and CAD in diabetic patients with suboptimal and poor long-term glycemic control, further emphasizing the need for aggressive risk factor modification to minimize vascular complications from DM.
