7. Prevalence of CAD in asymptomatic type II diabetics, using MPI as screening tool. Single center cross sectional study from KSA

Abstract

Clinical research. Oral presentation. In patients with type 2 diabetes coronary artery disease (CAD) is a major cause of mortality and morbidity. Knowing the elevated risk of cardiovascular events and high prevalence of silent myocardial ischemia, screening asymptomatic diabetic patients-yet controversial-is appealing. The aim of the study is to measure the prevalence of silent ischemia in asymptomatic type-II diabetic patient with at least one or more of the given risk factors i.e. Hypertension, Dyslipidemia, Smoking, obesity and F/H of CAD. Myocardial perfusion Imaging is a sensitive test to look for myocardial ischemia. This is a single center cross sectional study, approved by the institutional review board of the hospital. The study subjects were type-II diabetes of >5 years duration, asymptomatic, having one or more of the risk factors; The subjects were screened for CAD using myocardial perfusion imaging (MPI). Further intervention or treatment was left to primary physician in case of positive results. A total of 137 patients-after obtaining an informed consent-underwent MPI. There were no complications during the tests. All of the patients tolerated the test well. ECGs were obtained. Two independent reviewers (blinded to each other’s findings) reviewed tests. A test was considered ”Positive” only if both reviewers results matched (in distribution, severity and size). Of 137 cohort, 21(15%) showed perfusion defects consistent with significant myocardial ischemia in a specific coronary artery distribution. Average sum stress score (SSS) was 5 (range 4–8, mode 4). Of the whole group, patients with higher HbA1C had the positive MPI. Results of positive patients were relayed to their primary physicians. Despite higher rate of diabetes in Saudi Arabia, asymptomatic Diabetics have a lower than expected incidence of active CAD. There would be a need to test this notion further. This would require more studies to confirm our findings in Saudi population.