Study of prevalence of asymptomatic coronary artery disease in patients with diabetes mellitus by treadmill test
Author(s): Dr. Rajashree Ampar Nataraj, Dr. Shivani Shivaprasad, Dr. Varun Kumar Methuku and Dr. Shivakumar Bangalore Raja
Abstract:Introduction and Aim: Coronary artery disease (CAD) is the leading cause of death in patients with type 2 diabetes and is often asymptomatic because of silent myocardial ischemia. Periodical clinical examination and resting electrocardiogram may fail to detect coronary artery disease. Exercise electrocardiograph can identify the majority of patients likely to have significant ischaemia during their daily activities and remains the most important screening test for significant CAD. This study was conducted to analyse the prevalence of ischemic changes in asymptomatic type 2 diabetic patients Materials and methods: by exercise treadmill test. This study was conducted at one of the tertiary health care centre in Bangalore, India between 2008 to 2011. This study was approved by the Ethics Committee of the Hospital. This is a cross sectional study done on 102 patients of type 2 diabetes mellitus without clinical and electrocardiographic evidence of coronary artery disease attending Medicine OPD. Patients of type 2 diabetes mellitus without clinical evidence of coronary artery disease, normal resting 12 lead electrocardiogram and without past history of IHD, CVA and hypertension who provided consent were included in the study. Patients suffering from IHD, severe Osteoarthritis, having abnormal resting ECG were excluded from the study. Data was obtained by history, relevant clinical examination and resting electrocardiogram. All of them underwent treadmill test according to modified Bruce protocol. Heart rate response to Valsalva maneuver, heart rate response to sustained handgrip and postural fall in blood pressure were the tests performed for recognition of autonomic neuropathy. The data was analyzed by using the SPSS software. The prevalence rate was expressed in terms of percentage.
Results: The prevalence of asymptomatic coronary artery disease in type 2 diabetes mellitus was found to be 31.37%. Among diabetic patients with Autonomic neuropathy, TMT was positive in 12 patients and negative in 8 patients (60 Vs 40%).
Conclusion: This study stresses the need of evaluation of Diabetic patients with exercise thread mill test for detecting asymptomatic coronary artery disease so that early intervention can reduce the morbidity.
Dr. Rajashree Ampar Nataraj, Dr. Shivani Shivaprasad, Dr. Varun Kumar Methuku, Dr. Shivakumar Bangalore Raja. Study of prevalence of asymptomatic coronary artery disease in patients with diabetes mellitus by treadmill test. Int J Adv Res Med 2021;3(1):158-162. DOI: 10.22271/27069567.2021.v3.i1c.121