Assessment of Asymptomatic Coronary Heart Disease in Type 2 Diabetics with Treadmill Test and Framingham 10-Year CHD Risk Scoring System

Abstract

Background and objectives: Coronary Heart Disease (CHD) has a high prevalence in Asian Indians & is the leading cause of morbidity & mortality in patients with type 2 diabetes due to silent myocardial ischemia. This needs early cardio vascular assessment through non invasive tests e.g. Treadmill Test (TMT) & Framingham 10-year CHD risk in addition to periodical clinical examination & resting electrocardiogram. Methods: 102 known north Indian diabetics without clinical & electrocardiographic evidence of CHD were evaluated for smoking, blood pressure, glycosylated hemoglobin, fasting & post-prandial blood sugar & lipid profile to calculate Framingham score system for 10-year CHD risk assessment along with exercise treadmill test. Results: Among 102 diabetic patients, TMT was positive in 32 (31.37%) patients; more in males (59.73%). Mean cholesterol (189.81 mg %), triglycerides (135.19 mg %) and LDL (116.28 mg %) levels were significantly high in TMT positive cases (P 20%), 28 intermediate (≥10-19.9%) & 51 low ( Conclusion: A 6-fold higher incidence between low & intermediate, 2.4-fold between intermediate & high and 14-fold between low & high Framingham 10-year CHD risk groups is suggestive of higher incidence of TMT positive cases correlates with higher Framingham 10-year CHD risk & are more prone for asymptomatic CHD in north Indian diabetics. Key words: Coronary heart disease, Electrocardiogram, Framingham 10-year CHD risk, Treadmill test, Type 2 diabetes.