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Electrocardiography-defined silent CHD and risk of cardiovascular events among diabetic patients in a Middle Eastern

Farzad Hadaegh1, Masumeh Hatami, Reza Mohebi

  • 1Shahid Beheshti University of Medical Sciences, Tehran, Iran. fzhadaegh@endocrine.ac.ir

European Journal of Preventive Cardiology
|October 21, 2011
PubMed

Insights

Symptomatic coronary heart disease (CHD) predicts cardiovascular disease (CVD) in diabetic patients. For diabetic men with asymptomatic CHD, electrocardiogram (ECG) results offer prognostic value for CVD and CHD events.

Area of Science:

  • Cardiology
  • Diabetology
  • Public Health

Background:

  • Coronary heart disease (CHD) is a significant concern in patients with type 2 diabetes.
  • Understanding the clinical outcomes of symptomatic versus asymptomatic CHD in this population is crucial for risk stratification and management.
  • Existing guidelines suggest further cardiac testing for diabetic patients with abnormal resting electrocardiograms (ECGs).

Purpose of the Study:

  • To assess the clinical outcomes of symptomatic and asymptomatic coronary heart disease (CHD) in patients with type 2 diabetes.
  • To evaluate the prognostic value of electrocardiogram (ECG) findings in diabetic individuals with varying CHD statuses.
  • To provide evidence-based support for current recommendations regarding cardiac testing in diabetic patients.

Main Methods:

  • A population-based cohort study was conducted.
  • The study included 380 men and 546 women aged 30 years or older with type 2 diabetes.
  • Participants were categorized into four groups based on CHD symptoms and ECG findings: no CHD/normal ECG, silent CHD, symptomatic CHD/normal ECG, and symptomatic CHD/ECG-determined CHD. Cox regression analysis was used to estimate hazard ratios for cardiovascular disease (CVD) and CHD events.

Main Results:

  • During a median follow-up of 9.2 years, 226 CVD events and 202 CHD events occurred.
  • In multivariable-adjusted models, symptomatic CHD (regardless of ECG) was an independent predictor of CVD/CHD events in both men and women.
  • For diabetic men with asymptomatic CHD, abnormal ECG findings were associated with significantly increased risks of CVD and CHD events (HRs ranging from 2.32 to 3.97).

Conclusions:

  • Symptomatic coronary heart disease (CHD) is a significant independent predictor of recurrent cardiovascular disease (CVD) and CHD events in diabetic patients of both sexes.
  • Electrocardiogram (ECG) results hold prognostic value for incident CVD and CHD events specifically in diabetic men with asymptomatic CHD.
  • The study provides evidence supporting the American Diabetes Association's recommendation for further cardiac testing in diabetic men with abnormal resting ECGs.
Abstract

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