EVALUATION OF SILENT MYOCARDIAL ISCHEMIA IN ASYMPTOMATIC TYPE 2 DIABETES MELLITUS PATIENTS BY TREAD MILL TEST IN TERTIARY CARE CENTER IN SOUTH INDIA
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 10
Abstract
BACKGROUND Diabetes is an important and treatable risk factor for Coronary Artery Disease (CAD). Routine electrocardiography (ECG) and cardiac imaging cannot diagnose these patients. Hence the present study was done to estimate the prevalence of silent myocardial ischemia (SMI) in asymptomatic type 2 diabetic patients by Tread Mill Test (TMT). Assess the role of Tread Mill Test (TMT) in detecting the prevalence of silent myocardial ischemia (SMI) in type 2 diabetic patients. MATERIALS AND METHODS Asymptomatic diabetes mellitus (DM) patients aged 30 to 60 years with a normal resting ECG and echocardiography (ECHO) were included in the study. A detailed clinical history, a thorough medical examination and relevant biochemical parameters were analysed in all study subjects. The treadmill test was performed on each participant according to the Bruce protocol. RESULTS In this study, the prevalence of silent myocardial ischaemia in asymptomatic DM patients was 22.2%, as shown by positive TMT test. Among these study subjects, 10 (22.7%) were males and 6 (21.4%) were females. Among the risk factors, association of age, duration of diabetes, HbA1c levels were correlated with TMT positivity for inducible ischemia. CONCLUSION The silent nature of CAD in many diabetes patients makes remain undiagnosed for long periods of time. Hence there is a need for screening of diabetes patients for MI. In a rural setup where there are limited resources, TMT can be used as a screening tool for diagnosing SMI. Elderly diabetics with longer duration of diabetes and poor glycemic control had higher prevalence of inducible ischemia. Good glycemic control had a protective effect against development CAD.
Authors and Affiliations
Malepati Sai Sarath Reddy, Uma Mylandlahalli Anandkumar, Srinivasa Rao
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