FACTORS ASSOCIATED WITH SILENT ISCHEMIA IN TYPE 2 DIABETIC PATIENTS

Authors

  • Vashisth A Department of Nephrology, IPGMER Kolkata, Kolkata, West Bengal, India. https://orcid.org/0009-0003-8347-4294
  • Sharma S Department of Nephrology, IPGMER Kolkata, Kolkata, West Bengal, India.
  • Patel R N Department of General Medicine, Ananya College of Medicine and Research, Kalol, Gujarat, India.
  • GUPTA P K American International Institute of Medical Sciences, Udaipur, Rajasthan, India. https://orcid.org/0000-0002-0247-6665

DOI:

https://doi.org/10.22159/ajpcr.2024.v17i3.49288

Keywords:

Trademill testing, silent myocardial ischaemi, Type 2 Diabetes mellitus

Abstract

Objective: The present study was conducted to study the role of treadmill testing (TMT) in identifying silent ischemia in diabetic patients and to assess factors associated with silent ischemia in them.

Methods: The study was a hospital-based cross-sectional study where 60 patients with type 2 diabetes between the age 40 and 60 years without an established clinical diagnosis of coronary artery disease attending medical OPD were included in the study. The TMT was done using a computerized CTMT machine with built-in protocols. Continuous electrocardiogram (ECG) recordings were taken.

Results: The prevalence of silent myocardial ischemia in type 2 asymptomatic diabetes mellitus in this study was found to be 28.3%. Smoking, higher age, alcohol intake, and duration of DM were found to be significantly associated with silent myocardial ischemia.

Conclusion: Thus, we conclude that the prevalence of silent myocardial ischemia is more common in diabetics. Early screening of asymptomatic patients with type 2 diabetes mellitus with the help of TMT for evidence of silent myocardial ischemia may prevent catastrophic cardiac events.

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References

Kishner S, Miller JP. Electromyography and Nerve Conduction Studies: Background, Indications, Contraindications; 2019. Available from: https://emedicine.medscape.com/article/2094544-overview

Quan D, Khardori R. Diabetic Neuropathy; 2012. Available from: https://img.medscape.com/pi/android/medscapeapp/html/a1170337- business.html

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care 2010;33:S62-9. doi: 10.2337/dc10-S062, PMID 20042775

Koistinen MJ. Prevalence of asymptomatic myocardial ischaemia in diabetic subjects. BMJ 1990;301:92-5. doi: 10.1136/bmj.301.6743.92, PMID 2390590

Achari V, Thakur AK. Treadmill testing in asymptomatic type 2 diabetes. JAPI 2002;50:50-3.

Hume L, Oakley GD, Boulton AJ, Hardisty C, Ward JD. Asymptomatic myocardial ischemia in diabetes and its relationship to diabetic neuropathy: An exercise electrocardiography study in middle-aged diabetic men. Diabetes Care 1986;9:384-8. doi: 10.2337/ diacare.9.4.384, PMID 3743313

Garg PK, Swaroop AK, Singla S. Silent myocardial ischaemia in type 2 diabetes mellitus. JAPI 2002;50:1471.

Murray DP, O’Brien T, Mulrooney R, O’Sullivan DJ. Autonomic dysfunction and silent myocardial ischaemia on exercise testing in diabetes mellitus. Diabet Med 1990;7:580-4. doi: 10.1111/j.1464- 5491.1990.tb01452.x, PMID 2146063

Gupta SB, Pandit RB. Silent myocardial ischemia and cardiac autonomic neuropathy I diabetes. Ind Heart J 1993;44:227-9.

Ahluwalia G, Jain P, Chugh SK, Wasir HS, Kaul U. Silent myocardial ischemia in diabetics with normal autonomic function. Int J Cardiol 1995;48:147-53. doi: 10.1016/0167-5273(94)02233-9, PMID 7774993

Sukhija R, Dhanwal D, Gambhir DS, Dewan R. Silent myocardial ischaemia in patients with type II diabetes mellitus and its relation with autonomic dysfunction. Indian Heart J 2000;52:540-6. PMID 11256776

Kuusisto J, Lempiäinen P, Mykkänen L, Laakso M. Insulin resistance syndrome predicts coronary heart disease events in elderly type 2 diabetic men. Diabetes Care 2001;24:1629-33. doi: 10.2337/ diacare.24.9.1629, PMID 11522711

Suastika K, Dwipayana P, Siswadi M, Tuty RA. Age is an important risk factor for type 2 diabetes mellitus and cardiovascular diseases. In: Glucose Tolerance. Croatia: InTech; 2012.

Oki GC, Pavin EJ, Coelho OR, Parisi MC, Almeida RC, Etchebehere E, et al. Myocardial perfusion scintigraphy in the detection of silent ischemia in asymptomatic diabetic patients. Radiol Bras 2013;46:7-14. doi: 10.1590/S0100-39842013000100007

Turner RC, Millns H, Neil HA, Stratton IM, Manley SE, Matthews DR, et al. Risk factors for coronary artery disease in non-insulin dependent diabetes mellitus: United Kingdom prospective diabetes study (UKPDS: 23). BMJ 1998;316:823-8. doi: 10.1136/bmj.316.7134.823, PMID 9549452

Kothari V, Stevens RJ, Adler AI, Stratton IM, Manley SE, Neil HA, et al. UKPDS 60: Risk of stroke in type 2 diabetes estimated by the UK prospective diabetes study risk engine. Stroke 2002;33:1776-81. doi: 10.1161/01.str.0000020091.07144.c7, PMID 12105351

Morrish NJ, Stevens LK, Fuller JH, Jarrett RJ, Keen H. Risk factors for macrovascular disease in diabetes mellitus: The London follow-up to the WHO multinational study of vascular disease in diabetics. Diabetologia 1991;34:590-4. doi: 10.1007/BF00400279, PMID 1936663

Sakuta H, Suzuki T, Katayama Y, Yasuda H, Ito T. Heavy alcohol intake, homocysteine and type 2 diabetes. Diabet Med 2005;22:1359- 63. doi: 10.1111/j.1464-5491.2005.01653.x, PMID 16176197

Polsky S, Akturk HK. Alcohol consumption, diabetes risk, and cardiovascular disease within diabetes. Curr Diab Rep 2017;17:136. doi: 10.1007/s11892-017-0950-8, PMID 29103170

Published

07-03-2024

How to Cite

A, V., S. S, P. R N, and G. P K. “FACTORS ASSOCIATED WITH SILENT ISCHEMIA IN TYPE 2 DIABETIC PATIENTS”. Asian Journal of Pharmaceutical and Clinical Research, vol. 17, no. 3, Mar. 2024, pp. 37-39, doi:10.22159/ajpcr.2024.v17i3.49288.

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