Treadmill Test to Detect Stress Induced Ischemic Heart Disease in Type 2 Diabetes Mellitus Patients Asymptomatic for CAD: A Hospital Based Cross-sectional Study in Rural Population of Central India

Lavekar, Anurag

doi:10.4172/2155-6156.1000244

Cited by 10 publications

(18 citation statements)

References 13 publications

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“…The mean age study subjects were 54.7 years. Similar results were seen by Swaminathan K et al 13 (52.3 ± 5.6) and Lavekar AS et al 14 (53.56 ± 7.41). This may reflect the health-seeking behaviour of study subjects after the age of 40 years.…”

Section: Discussionsupporting

confidence: 88%

“…A strong association between poor glycaemic control and inducible ischaemia has been observed by Lavekar AS et al The mean value of FBS in the present study is 141 mg/dl, which is closer to mean observed in Khanapure SP et al In the present study, the mean BMI of study subjects was 24.84 kg/m 2 . Similarly, in the study involving the rural population of Maharashtra by Lavekar AS et al 14 the mean BMI of the subjects were 25.62 kg/m 2 . However, in the study by Khanapure SP et al involving an urban population of Karnataka the mean BMI of the subjects were 30.44 kg/m 2 which is higher compared to the present study.…”

Section: Discussionmentioning

confidence: 73%

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Evaluation of Silent Myocardial Ischemia in Asymptomatic Type 2 Diabetes Mellitus Patients by Tread Mill Test in Tertiary Care Center in South India

Reddy¹,

Anandkumar²,

Rao³

2019

jemds

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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.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 73%

Evaluation of Silent Myocardial Ischemia in Asymptomatic Type 2 Diabetes Mellitus Patients by Tread Mill Test in Tertiary Care Center in South India

Reddy¹,

Anandkumar²,

Rao³

2019

jemds

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“…Routine screening of type 2 diabetics for asymptomatic coronary artery disease with ECG remains controversial, as majority of them present with normal ECG(American Diabetes Association 2010). However, progressive coronary artery disease remains asymptomatic in many cases of type 2 diabetes and this makes diagnosis difficult at proper time Many studies have been published showing relationship between DM and silent ischemia (Lavekar and Salkar 2013).…”

Section: Silent Ischemiamentioning

confidence: 99%

“…Additionally, screening asymptomaticT2DMpatients with myocardial perfusion imaging may produce a significant number of high-risk scans (Cosson et al, 2011;Kumar 2014;Lavekar and Salkar 2013;Upchurch and Barrett 2012). One retrospective study suggested that some of these scans will uncover patients with angiographic findings that merit surgical revascularization (left main, three-vessel, and/or proximal left anterior descending) (Rajagopalan et al, 2005), possibly leading to better survival with coronary artery bypass grafting (CABG) over medical therapy.…”

Section: Silent Ischemiamentioning

confidence: 99%

Role of Treadmill testing (TMT) in Type Two diabetic Patients in Kirkuk - A Prospective Clinical Study

Salih¹,

Mohammed²

2018

Int.J.Curr.Res.Aca.Rev.

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Article Info Coronary artery disease is the common impact of death worldwide in type 2 Diabetes mellitus. High rate of asymptomatic coronary heart disease in type 2 DM. Stress testing, and subsequent intervention, might reduce patients" risk of cardiovascular morbidity and mortality. Hence a prospective study conducted during the period 2016-2017We studied the prevalence of silent myocardial ischemia (SMI) in asymptomatic type 2 diabetes mellitus by using treadmill test. Further analysis was performed using binary logistic regression for the predictors of positive TMT findings in DM patients in this study, the duration of DM was the stronger significant predictor of positive TMT, [odds ratio (OR = 2.79), P = 0.002], patients with longer duration of DM were about 2.8-fold more likely to have positive TMT findings. Being old age diabetic male patient increase the risk of having positive TMT by almost 1.82 folds (OR = 1.82, P = 0.023), other were higher level of Triglycerides (OR = 1.68), larger BMI (OR = 1.44), and male gender (OR = 1.33). In conclusion, the current study documented that a significant proportion of type two diabetes mellitus patients had silent myocardial Ischemia detected by treadmill testing which showed an important role in detecting the silent myocardial ischemia older age, male gender, longer duration of diabetes, large body mass index and elevated triglycerides levels are significant predictors of silent myocardial ischemia in diabetic patients.

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“…Coronary Artery Disease (CAD) is multifactorial in aetiology and has several important risk factors, out of which diabetes is one of the important modifiable risk factor. 5 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.…”

Section: Introductionmentioning

confidence: 99%

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

Deb¹,

Narzary²,

Kar³

2016

jemds

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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.

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Treadmill Test to Detect Stress Induced Ischemic Heart Disease in Type 2 Diabetes Mellitus Patients Asymptomatic for CAD: A Hospital Based Cross-sectional Study in Rural Population of Central India

Cited by 10 publications

References 13 publications

Evaluation of Silent Myocardial Ischemia in Asymptomatic Type 2 Diabetes Mellitus Patients by Tread Mill Test in Tertiary Care Center in South India

Evaluation of Silent Myocardial Ischemia in Asymptomatic Type 2 Diabetes Mellitus Patients by Tread Mill Test in Tertiary Care Center in South India

Role of Treadmill testing (TMT) in Type Two diabetic Patients in Kirkuk - A Prospective Clinical Study

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

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