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Detection of asymptomatic coronary artery disease among patients with type 2 diabetes mellitus using treadmill test
Gagan Gunjan1, Ritesh L Chauhan2, Pushpendra Singh Sengar3
1Department of Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
Abstract:
Type 2 diabetes mellitus (T2DM) is strongly associated with silent myocardial ischemia (SMI), an asymptomatic form of coronary artery disease (CAD) and making early detection vital to prevent cardiac events. Therefore, it is of interest to evaluate 75 asymptomatic T2DM patients (mean age 53.27 ± 9.22 years) using the treadmill test (TMT) with the Bruce protocol and compared clinical and biochemical parameters between TMT-positive and negative groups. TMT was positive in 20 patients (26.66%), who were significantly older and had longer diabetes duration, higher HbA1c, fasting and postprandial glucose levels and adverse lipid profiles compared to TMT-negative patients. Dyslipidemia, elevated triglycerides and LDL and reduced HDL were particularly prominent among TMT-positive individuals. Thus, we show that longer disease duration, poor glycemic control and dyslipidemia are strong predictors of asymptomatic CAD and TMT is a useful non-invasive tool for its early detection in T2DM patients.
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