P 5: Value of the UKPDS risk score in the screening of asymptomatic type 2 diabetic patients for coronary stenoses and artery stiffness

Abstract

Rationale and aims In patients with type 2 diabetes silent coronary disease was shown to be predictive of major cardiac events. Thus, the detection of silent myocardial ischemia (SMI) and silent coronary stenoses is challenging. Artery stiffness is also associated with a worse prognosis. The aim of this study was to examine the value of the UKPDS risk score for coronary events in the algorithm of screening for SMI, coronary stenoses and artery stiffness in patients with type 2 diabetes. Patients and Methods We included 116 patients (65 women and 51 men), aged 55.4 ± 11.8 years, without known cardiovascular disease and with normal resting ECG but at high cardiovascular risk. SMI was assessed on an ECG stress test, and a coronary angiography was carried out in the patients with SMI. Significant coronary stenoses (SCS) were defined as ≥ 70% (or 50% for the main left coronary artery). The 10-year coronary risk of non fatal events was estimated using the UKPDS risk engine. Aortic pulse wave velocity (PWV) was measured (CompliorO). Results The prevalence of hypertension, obesity, dyslipidemia, nephropathy and smoking was 61.2%, 47.2%, 52.6%, 36.2 and 6%, respectively. SMI was found in 59 patients. A coronary angiography was performed in 51 of them, and 22 (15 men and 7 women) had SCS. The coronary risk score was 18.8±16.0%, and was significantly higher in men than in women (29.4±18.3% vs 10.6±6.8%, p Conclusion In this population of type 2 diabetic patients at high cardiovascular risk, an UKPDS risk score for non fatal coronary events ≥ 15% was associated with a significantly increased risk of artery stiffness and silent coronary stenoses. This score may help in screening patients who should be tested for these disorders.