The Diagnostic Value of Single Photon Emission Tomography (SPECT) Stress Test in Diabetic Patients With Suspected Coronary Artery Disease in Correlation to Invasive Coronary Angiogram

Abstract Background Invasive coronary angiography (ICA) is the procedure of choice for the diagnosis of coronary artery disease (CAD). ICA allows for a clear visualization of the coronary arterial blood flow, which helps in the diagnosis and treatment decision.Single-photon emission computed tomography (SPECT) is currently in widespread use to evaluate patients known or suspected to have coronary artery disease (CAD). Our aim is to examine the association between (SPECT) stress test and elective ICA in terms of diagnostic value in Diabetic patients suspected to have coronary artery disease. Methods A retrospective case-control study using a non-probability consecutive sampling technique for the selection of the study population conducted at King Faisal Cardiac Center, Jeddah. The study included all diabetic patients presented with stable angina and did exercise or pharmacologic myocardial perfusion SPECT study followed by elective ICA. Results 207 patients met the inclusion and exclusion criteria. 43% (n=90) patients were females, and 57% (n=117) were males. 68% (n=141) patients were in the agreement group and the other group had 32% (n=66) patients who had a discrepancy in the results of the SPECT and ICA. In comparing the results of SPECT to the ICA, SPECT had a sensitivity of 92.4%, and a specificity of 26.3%. Conclusion:The reliability between the SPECT and ICA was measured to be 0.4 which is a moderately strong level of agreement. The accuracy of detecting or ruling out CAD in patients with diabetes or hypertension was higher in the agreement group. These results deviate toward a trend that resembles recent literature.