Diabetes mellitus: evaluation of patients with known or suspected coronary artery disease and the role played by myocardial perfusion imaging

Type 2 diabetes markedly increases cardiovascular risk, and patients often present with advanced and asymptomatic disease. The fact that diabetes is associated with an increased risk of acute coronary events and poor long-term survival makes a strong case for detecting coronary artery disease early, perhaps before clinical manifestation in this patient population. This article examines the role of myocardial perfusion scintigraphy in the diagnostic and prognostic evaluation of diabetic patients with suspected coronary artery disease and in screening high-risk asymptomatic diabetic patients.