Korean J Intern Med.  2009 Sep;24(3):183-189. 10.3904/kjim.2009.24.3.183.

Early Detection Of Asymptomatic Coronary Artery Disease In Patients With Type 2 Diabetes Mellitus

• Yoo WS
• Kim HJ
• Kim D
• Lee MY
• Chung HK

• KMID: 1717940
• DOI: http://doi.org/10.3904/kjim.2009.24.3.183

Abstract

BACKGROUND/AIMS
In type 2 diabetic patients, coronary artery disease (CAD) is usually detected at an advanced stage due to a lack of symptoms. The aim of this study was to define which clinical parameters or non-invasive tests predict CAD in asymptomatic type 2 diabetic patients. METHODS: One hundred fourteen asymptomatic type 2 diabetic patients were divided into two groups based on the number of cardiovascular disease (CVD) risk factors (group A > or =2, group B < or =1). Treadmill exercise ECG tests (TMT) were conducted in all cases, and coronary artery angiography was performed on TMT-positive patients. Clinical parameters, diabetic status, and coronary angiographic findings were analyzed. RESULTS: The prevalence of CAD was 41.0% in group A and 16.7% in group B. The number of risk factors was significantly correlated with the prevalence of CAD, but not with the severity of CAD. Multivariate analysis showed that family history of CAD (odds ratio [OR]=9.41; 95% confidence interval [CI], 1.60-55.49) and diabetes duration > or =10 years (OR=3.28; 95% CI, 1.29-8.84) were independent CAD risk factors in asymptomatic patients. CONCLUSIONS: We recommend a routine screening for CAD in type 2 diabetic patients who have a longer (> or =10 years) diabetic duration or a family history of CAD, even if they are asymptomatic for CAD.

Keyword

Diabetes mellitus, type 2; Coronary artery disease; Early diagnosis; Risk factors

MeSH Terms

Adult
Aged
Coronary Artery Disease/*diagnosis
Diabetes Mellitus, Type 2/*complications
Early Diagnosis
Exercise Test
Female
Humans
Male
Middle Aged
Prospective Studies
Risk Factors