Researchers from the University of Hong Kong said on Tuesday combining imaging technology with an anti-diabetic drug could bring better treatment outcomes for diabetics with coronary artery disease.

Diabetics often suffer from coronary artery disease due to the narrowing or full blockage of the blood vessels.

The HKU team analysed treatment outcomes for 671 patients with both conditions from 2014 to 2016.

In a two-part study, researchers identified 187 out of these 671 who needed but didn’t receive coronary stents back then with the coronary angiography-derived fractional flow reserve (caFFR) imaging technology.

They were found to face higher risks of major cardiovascular events or death over a three-year period after receiving other forms of treatment.

“This new technique not only tells you the percentage of obstruction, it also tells you the amount of insufficient blood supply to the heart muscles,” said professor Yiu Kai-hang from the HKU’s department of medicine.

“So we demonstrated that by using this technique, we may be able to identify more patients who require stenting and accurately treat these patients accordingly, which would reduce their mortality [risks] by up to 70 percent.”

The second part of the study, Yiu said, found that diabetics on sodium-glucose co-transporter 2 (SGLT2) inhibitors, which prevent the kidneys from reabsorbing sugar back into the bloodstream, faced lower risks and mortality rate overall, even if doctors hadn't managed to completely revascularise them.

“So the second part of this study is the use of SGLT2 inhibitors... Even if we can't completely revascularise the patients, the use of SGLT2 inhibitors remains useful for [dealing with] this high risk to a patient.”

While the caFFR technique is already available in both public and private facilities, Yiu noted that only 10 percent of patients received the assessments that it offered.

Only about 20 percent of diabetics take SGLT2 inhibitors despite doctor's recommendations, he added.

“I think a lack of awareness or knowledge gap is the key reason,” Yiu said.

“Besides understanding, I think especially for the drugs, a lot of the patients do not understand not only the benefit, but they also do not understand the potential side effects.”

According to Yiu, up to 7 percent of patients would develop urinary tract infections after intake of SGLT inhibitors.

“So this is the key reason why these patients cannot remain on this medication, because they feel that this medication is actually causing side effects and they don't want to take it anymore, which is not a correct way,” he said.

Yiu noted that future research would focus on developing different modalities to more accurately define patient’s risks and come up with personalised treatment options.