Abstract
Background: Cardiovascular disease is a major cause of morbidity and mortality in diabetics. However diabetic patients do not present with typical anginal symptoms or may be even asymptomatic and silent coronary artery disease (CAD) is prevalent in diabetics. Moreover silent CAD is not different from symptomatic CAD with respect to prognosis and adverse effects. Aim: The study was done to demonstrate the prevalence of silent myocardial ischemic changes in asymptomatic type 2 diabetes mellitus patients with normal resting ECG by doing a stress exercise test. Methodology: This descriptive study was done in 100 patients with type 2 diabetes more than 2 years who did not have any history of cardiovascular disease or symptoms. Detailed history was taken and investigations such as HbA1c, fasting and postprandial blood sugar, serum creatinine, urine examination were done. Resting ECG, Echocardiogram was found to be normal and they were subjected to a treadmill test. Results: Among the 100 participants 18 persons (18%) had positive ECG findings in treadmill test. A positive association was found between the duration of diabetes and prevalence of positive treadmill test. Conclusion: There is significant prevalence of silent CAD in diabetic patients and they tend to present with advanced disease at presentation and have poorer prognosis compared to non diabetic population. Hence it is necessary to screen early for silent CAD in diabetics to improve disease outcomes.
Highlights
The prevalence of diabetes mellitus has increased exponentially over the past two decades
A positive association was found between the duration of diabetes and prevalence of positive treadmill test
There is significant prevalence of silent coronary artery disease (CAD) in diabetic patients and they tend to present with advanced disease at presentation and have poorer prognosis compared to non diabetic population
Summary
The prevalence of diabetes mellitus has increased exponentially over the past two decades. Factors in diabetes like increased oxidative stress, increased coagulability, endothelial dysfunction have a direct role in the pathogenesis of coronary artery disease (CAD) [3]. These mechanisms that are unique to diabetes contribute to the pathophysiology of cardiac disease in addition to and independent of other risk factors like hypertension and dyslipidemia [4]. Diabetic patients do not present with typical anginal symptoms or may be even asymptomatic and silent CAD disease is common in diabetics [5]. Diabetic patients do not present with typical anginal symptoms or may be even asymptomatic and silent coronary artery disease (CAD) is prevalent in diabetics. Silent CAD is not different from symptomatic CAD with respect to prognosis and adverse effects
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