[en] The objective of the present study was to assess the prevalence of coronary artery disease (CAD) among diabetic (DM) and nondiabetic (NDM) women using Gated SPECT (GSPECT) and to study the impact of other. risk factors like hypertension (HTN), dyslipidemia, family history and menopause. This is a prospective cross-sectional study on a consecutive sample of 287 women referred to Nuclear Cardiology Department of Karachi Institute of Heart Diseases (KIHD) for GSPECT for evaluation of known or suspected CAD (from January 2009 till June 2009). Women with a history of DM diagnosed less than 5 years were excluded. Same day (reststress) GSPECT study was conducted and fixed or reversible perfusion defects were considered positive GSPECT for CAD. GSPECT was positive for CAD in 41/115 (36%, P 0.002) diabetic women and 37/172 (21 %, P 0.005) non-diabetic cohort. In diabetic cohort, GSPECT was positive in 5/9 (56%, P 0.013) women with diabetes only, 17/35 (48%, P 0.02) DM with HTN, 12/15 (80%, P value 0.02) DM with dyslipidemia and 11/43 (26%, P 0.001) DM with >2 risk factors. GSPECT was normal in all 3 diabetic women with positive family history for CAD. In nondiabetic cohort, GSPECT was positive in 9/32 (28%, P value 0.739) women with no risk factor, 5/58 (26%, P 0.866) HTN only, 2/5 (40%, P value 0.655) only dyslipidemic women, 1/12. (8%, P 0.004) with family history only and 4/23 (17%, P value 0.166) non-diabetic with >2 risk factors. Interestingly, 35/93 post-menopausal diabetic (38%, p value 0.017) had positive GSPECT while 33/123 non-diabetic postmenopausal women (27%, p 0.03) had positive perfusion scans. GSPECT was positive in 6/26 (23%, P 0.006) and 4/49 (8%, P 0.05) in diabetic and non-diabetic pre-menopausal women. The prevalence of CAD in our diabetic women is as high as internationally reported and diabetes is a strong risk factor for CAD. Dyslipidemia with diabetes is a major contributor to CAD than HTN and F/H. Diabetes erases the protective effect of estrogen in premenopausal diabetic women. (author)

[en] In order to compare myocardial perfusion using 99mTc Tetrofosmin ECG gated myocardial perfusion single photon emission computed tomography (ECG gated MP-SPECT) with coronary angiography, this descriptive study was performed in 47 patients. Sensitivity and specificity of myocardial perfusion scan with coronary angiography were calculated in all of the coronary vessels and individual coronary vessel. The sensitivity of perfusion scan of myocardium in case of LAD was 94.28% and the specificity was 91.66%. For LCX these figures were 82.35% and 90% and for RCA, 95.83% and 78.26% Respectively The overall sensitivity and specificity of myocardial perfusion scan in all of the coronary vessels was 91.66% and 81.81 % respectively. Our findings are consistent with other published studies. (author)

[en] Due to scarcity of local data regarding frequency of Renal Artery Stenosis (RAS), it is important to perform simultaneous renal arteriography in Patients undergoing coronary arterteriography for suspected coronary artery disease (CAD), in order to recognize all potential candidates for renal artery stenosis. It is cross sectional study. Three hundred patients, 157 male and 143 female with average age of 56+-8 Years and 55+-7 years respectively underwent simultaneous coronary and renal arteriography. Renal artery stenosis (RAS) was identified in 23.6% patients. Significant RAS (>50%) was present in 15% of patients. Hypertension, Dyslipidemia, smoking and diabetes mellitus were present in 88%, 80%, 50% and 49% respectively. Three vessel, two vessel and single vessel disease were seen in 58 %, 36% and 6% of patients. It is important to do simultaneous coronary and renal arteriography especially in patient having multiple risk factors and multi vessel coronary artery disease. (author)

[en] Coronary artery perforation, (CP) is a rare and potentially life-threatening complication of percutaneous coronary intervention (PCI). CP has historically been reported to occur in 0.1-3.0% of PCI procedures. Although CP can be caused by coronary wires and balloon angioplasty, they are more frequently reported in PCI using atheroablative devices, stenting and excimer laser coronary angioplasty. We report a case of coronary perforation took place and was managed successfully. (author)