Noninvasive assessment of cardiac risk in type I diabetic patients being evaluated for combined pancreas-kidney transplantation using dipyridamole-MIBI perfusion tomographic scintigraphy

This study was performed to determine the value of dipyridamole-Tc-99m-meth oxy-isobutyl isonitrile perfusion ((TC)-T-99m-MIBI) tomographic scintigraph y in the assessment of cardiac risk in patients being evaluated prior to co mbined pancreas-kidney transplantation (PKT). We performed perfusion tomogr aphic scintigraphy using single photon emission computed tomography (SPECT) on 77 patients. The tomographic images did not show clinically relevant fi ndings in 65 patients In the remaining 12 patients, coronary arteriography was performed: 2 showed normal results, 4 showed no stenosis, and 6 showed significant stenosis (greater than or equal to 70 %). Seventy-two patients underwent PKT. During the follow-up (6-48 months), there were seven cardiac events, 4 patients with significant stenosis, and 3 with nonsignificant st enosis upon coronary arteriography, and all had pathological tomographic im ages. Tc-99m-MIBI tomographic scintigraphy may be useful in identifying pat ients at low risk of incurring cardiac events after PKT and may, in a large group of patients, obviate the need for routine coronary angiography.