Early detection of coronary artery disease in asymptomatic type 2 diabetes mellitus patients

Sarkar, Narayan Chandra; Jain, Siddhant; Sarkar, Prasanta Kumar; Tilkar, Mahendra; Modi, Nitin

doi:10.5455/2349-3933.ijam20150206

Cited by 4 publications

(5 citation statements)

References 4 publications

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“…7 Sarkar et al reported the prevalence of asymptomatic CAD in DM as 27.9%. 29 Thus prevalence of asymptomatic CAD in DM patients reported in our study is lower to the previous reports. Of the 19 patients who underwent CAG, stratification by DTS constituted low, medium and high risk groups as 47.4%, 36.8% and 15.8% respectively.…”

Section: Echo Vs Asymptomatic Cad and Cagcontrasting

confidence: 87%

Effective Early Screening Modalities for Asymptomatic Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

Khànal¹,

G²,

Sood³

et al. 2018

JCDR

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Background: Coronary artery disease (CAD) is often asymptomatic in type 2 diabetes mellitus (DM) patients until the onset of myocardial infarction (MI) or sudden cardiac death. The aim of this study was to evaluate the effective early screening modalities for asymptomatic CAD in patients with DM at a tertiary care hospital. Methods and Materials: Patients aged ≥ 40 years with DM of at least 5 years duration were included in the study. Patients underwent all routine investigations to detect additional risk factors of diabetes followed by sequential screening using echocardiography (echo), treadmill exercise ECG or NH3-stress PET. Results: There were 39 men and 45 women with a mean age of 57.7 ± 8.2 years. The mean duration of diabetes was 9.3 ± 3.2 years and the mean HbA1c level was 7.98 ± 1.18 %. The sensitivity and specificity of echo was 15.4% and 94.4% respectively. Treadmill exercise ECG had a sensitivity of 73% and specificity of 35.3%. For NH3-stress PET with reversible perfusion defect (RPD) > 10%, the sensitivity and specificity of finding significant lesion on coronary angiography (CAG) was 100% and 83.3% respectively. Among various traditional risk factors for developing CAD, there was a strong statistical significance with hypertension, dyslipidemia and albuminuria (p < 0.05). Conclusion: Early screening for asymptomatic CAD among patients with DM is recommended especially for those who have DM of at least 5 years duration or have additional risk factors. Considering the cost and availability, treadmill exercise ECG should be considered as initial screening test followed by stratification with Duke Treadmill Score (DTS).

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Section: Echo Vs Asymptomatic Cad and Cagcontrasting

confidence: 87%

Effective Early Screening Modalities for Asymptomatic Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

Khànal¹,

G²,

Sood³

et al. 2018

JCDR

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show abstract

“…Sharda M et al, also recruited the study subjects in similar age range to authors and mean age was 52.96 years. 8 Thus age distribution was found to be similar to previous studies mean age in the study was less compared to other studies.…”

Section: Age and Gendersupporting

confidence: 87%

“…Sarkar NC et al, from India, evaluated 47 asymptomatic diabetics who underwent exercise ECG and autonomic function testing. 8 63.8% had >1 autonomic test abnormal and 46.8% had >2 autonomic tests abnormal, 38.3% had abnormal responses on TMT and those with autonomic dysfunction had a greater prevalence of silent ischemia than those without (59% vs 20%). Further, to validate the results coronary angiography was carried out in 9 patients who were TMT positive and 4 patients who were TMT negative.…”

Section: Tread Mill Tests Between Study Groupsmentioning

confidence: 97%

Treadmill test as a screening tool for detecting silent myocardial ischemia in type 2 diabetes patients: a case control study from Raipur, Chhattisgarh, India

et al. 2020

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Background: The incidence of diabetes mellitus (DM) is increasing substantially worldwide. CAD silently progresses over years in the diabetics. Diabetic individual appears to be less able to perceive some of the symptoms and signs of ischemia or may have asymptomatic ‘classic silent ischemia’. Thus, screening for early detection of asymptomatic CAD in type 2 diabetes may be helpful to prevent these catastrophic cardiac events and consequent deaths. Objectives of the study was to assess utility of TMT in Type 2 diabetic mellitus subjects to detect silent myocardial infarction.Methods: Hospital based observational analytical case control study was conducted in Department of Medicine in Dr BRAM Hospital Raipur during August 2016 to September 2018. Cases were 45 subjects of Type 2 Diabetes mellitus with normal ECG and controls were 45 subjects of Type 2 Diabetes Mellitus with abnormal resting ECG. Data analyzed using SPSS 17 version.Results: Majority i.e. 40% were found to be in fifth decade of their life. 71 (78.9%) male subjects and 19 (21.1%) female subjects. TMT was found positive in 8(17.8%) subjects with positive ECG changes whereas in 12(26.7%) subjects with no ECG changes. No significant difference was noted between distribution of any parameters except for hypertension which was found to be significantly higher in TMT positive subjects compared to TMT negative subjects.Conclusions: No significant difference was observed regarding TMT findings between T2DM subjects with and without ECG changes. Type 2 diabetes mellitus subjects with dyslipidemia, and hypertension are at higher risk of Positive TMT.

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“…10 However, Sarkar et al in their study obtained a p=0.2085, concluding the correlation between to be insignificant. 9 In the present study, only 7 out of the total 32 TMT positive patients were hypertensive. A p=0.733 was obtained, the correlation was insignificant.…”

Section: Discussioncontrasting

confidence: 45%

Study of exercise treadmill test in type 2 diabetes mellitus patients

Nagrani¹,

Patil²,

Barsode³

et al. 2021

Int J Adv Med

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Background: The aim of this study was to assess the prevalence and clinical predictors of silent myocardial ischemia in patients with type 2 diabetes mellitus, and the early diagnosis of coronary artery disease.Methods: A cross sectional prospective study was conducted including all confirmed diabetic patients in the age group between 40-60 in Bharati medical college hospital Pune in western Maharashtra. A detailed clinical examination and history was taken and relevant laboratory investigations, Electrocardiogram and Treadmill Stress test was done using Bruce protocol. The quantitative data was represented as their mean ± SD. Categorical and nominal data was expressed in percentage. All analysis was carried out by using SPSS software version 21.Results: Male preponderance was seen in the study with 64% of the study subjects. The mean age of the study subjects was 50.67±5.51 years. A p<0.001 was obtained showing positive correlation between BMI and TMT positivity. TMT positivity steadily increased with the duration of diabetes mellitus. Obtained p<0.001. The correlation between dyslipidemia and TMT positivity was significant, with a p=0.007. Correlation of Fasting as well as Post-prandial blood glucose levels with TMT positivity proved to be statistically significant, with a p<0.001.Conclusions: Exercise Treadmill test in diabetic patients has a significant role in screening diabetic individuals for coronary ischemia. The results obtained clearly indicate that an exercise treadmill test may be proposed as the first test for screening for coronary ischemia in diabetic population as it is safer, cheaper and non-invasive.

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Early detection of coronary artery disease in asymptomatic type 2 diabetes mellitus patients

Cited by 4 publications

References 4 publications

Effective Early Screening Modalities for Asymptomatic Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

Effective Early Screening Modalities for Asymptomatic Coronary Artery Disease in Patients with Type 2 Diabetes Mellitus

Treadmill test as a screening tool for detecting silent myocardial ischemia in type 2 diabetes patients: a case control study from Raipur, Chhattisgarh, India

Study of exercise treadmill test in type 2 diabetes mellitus patients

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