A Study of Electrocardiography and Treadmill Test in Type 2 Diabetic Patients Without Cardiac Symptoms

Abstract

Coronary artery disease is more common in diabetic population, but can be asymptomatic in many patients and may present with sudden death, myocardial infarction, arrhythmia, silent myocardial ischaemia or heart failure. Early detection of asymptomatic coronary artery disease in Type 2 Diabetes may prevent catastrophic cardiac events. However, periodical thorough clinical examination and resting Electrocardiogram (ECG) may fail to detect coronary artery disease. Noninvasive tests like exercise electrocardiography should then be proposed for early detection of asymptomatic CAD in these patients. AIM AND OBJECTIVESAim and objectives of the present study is to assess the prevalence of Coronary Artery Disease (CAD) in Type 2 Diabetic patients without any clinical evidence of CAD and to evaluate the patients with normal ECG by Treadmill Test. MATERIALS AND METHODThe present study was conducted in 100 consecutive Type 2 Diabetes mellitus patients, who attended Outpatient Department or were admitted in the Department of Internal Medicine at Silchar Medical College and Hospital, Silchar, for the period of 1 year from 1 st July, 2014 to 30 th June, 2015. RESULTS AND OBSERVATIONS50 patients in the study were in the age group 35-44 years, of these 40 were male and 10 were female; 33 patients were in the age group 45-54 of which 23 were male and 10 were female; 11 male and 6 female were in the age group 55-64. More number of subjects, i.e. 61 patients (61%) were having diabetes equal to or less than 5 years followed by 28 patients (28%) with the disease duration of more than 5 to 10 years, next 9 patients (9%) between more than 10 to 15 years and only 2 patients (2%) between more than 15 to 20 years of duration. The averages of glycosylated haemoglobin (HbA1C) was 7. 98, 7.66, 8.66 and 10.65, for the duration of diabetes equal to or less than 5 years, more than 5 to 10 years, more than 10 to 15 years and more than 15 to 20 years of disease duration respectively. Among 100 patients of our study, TMT result was positive in 27 patients (27%) and was negative in 73 patients (73%). Among the 27% of the TMT positive cases, 22.97% cases (17 patients) were males and 38.46% cases (10 patients) were females. The results of the specified duration of the disease, i.e. TMT positive were 16.39% (10/61 cases), 32.14% (9/28 cases), 66.66% (6/9 cases) and 100% (2/2 cases) with the duration of diabetes ≤5 years, >5-10 years, >10-15 years and >15-20 years respectively. CONCLUSIONIt can be inferred that early screening of patient with Type 2 Mellitus for the evidence of asymptomatic coronary artery disease is essential and the TMT positivity, i.e. possibility of Asymptomatic Coronary Artery Disease increases with longer duration of the disease.

A Cross-Sectional Study of Silent Myocardial Infarction Among Type 2 Diabetics.

“…The statistical significance of this outcome was established. Both Agarwal et al [12] and Deb et al [16] reported similar findings. Most patients with TMT positivity have been diagnosed with diabetes for more than 10 years, according to the findings of numerous studies conducted by Joshi et al [19] and Swaminathan and Gayathri [20].…”

“…According to previous research by Ditchburn et al [18], Deb et al [16], and Joshi et al [19], men made up the majority of study participants.…”

“…Many diabetic participants in this study, with an average age of 48.89 ± 6.1 years, were between 45 and 49. Most patients were between the ages of 35 and 44, according to Deb et al [16]. The average age was determined to be 46.20 ± 12.20 years by Daphale et al [17].…”

Exploring Silent Myocardial Infarction and Its Associations in Type 2 Diabetic Patients: A Cross-Sectional Study in a Hospital Setting.

“…The demographic characteristics, such as age and gender distribution, in this study, align with findings from prior investigations. In the investigation carried out by Dipankar Deb et al, [7] the predominant demographic consisted of individuals aged 35-44 years. In the study conducted by Amit Daphale et al [8], the average age of the participants was found to be 46.20 years.…”