DOI: http://dx.doi.org/10.18203/2349-3933.ijam20200501

Treadmill test as a screening tool for detecting silent myocardial ischemia in type 2 diabetes patients: a case control study from Raipur, Chhattisgarh, India

C. S. Sharma, Suyash Singh, R. K. Patel, V. N. Mishra, Shashank Gupta, Anant A. Takalkar

Abstract


Background: The incidence of diabetes mellitus (DM) is increasing substantially worldwide. CAD silently progresses over years in the diabetics. Diabetic individual appears to be less able to perceive some of the symptoms and signs of ischemia or may have asymptomatic ‘classic silent ischemia’. Thus, screening for early detection of asymptomatic CAD in type 2 diabetes may be helpful to prevent these catastrophic cardiac events and consequent deaths. Objectives of the study was to assess utility of TMT in Type 2 diabetic mellitus subjects to detect silent myocardial infarction.

Methods: Hospital based observational analytical case control study was conducted in Department of Medicine in Dr BRAM Hospital Raipur during August 2016 to September 2018. Cases were 45 subjects of Type 2 Diabetes mellitus with normal ECG and controls were 45 subjects of Type 2 Diabetes Mellitus with abnormal resting ECG. Data analyzed using SPSS 17 version.

Results: Majority i.e. 40% were found to be in fifth decade of their life. 71 (78.9%) male subjects and 19 (21.1%) female subjects. TMT was found positive in 8(17.8%) subjects with positive ECG changes whereas in 12(26.7%) subjects with no ECG changes. No significant difference was noted between distribution of any parameters except for hypertension which was found to be significantly higher in TMT positive subjects compared to TMT negative subjects.

Conclusions: No significant difference was observed regarding TMT findings between T2DM subjects with and without ECG changes. Type 2 diabetes mellitus subjects with dyslipidemia, and hypertension are at higher risk of Positive TMT.


Keywords


Silent MI, Screening tool, Trade mill, Type 2 diabetes

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References


Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27:1047-53.

Aguiree F, Brown A, Cho NH, Dahlquist G, Dodd S, Dunning T, et al. IDF Diabetes Atlas. 6th edition. International Diabetes Federation. Basel: Switzerland; 2013.

Centers for Disease Control and Prevention. National diabetes statistics report: Estimates of diabetes and its burden in the United States, 2014. Atlanta, GA: US Department of Health and Human Services; 2014.

Rivellese AA, Riccardi G, Vaccaro O. Cardiovascular risk in women with diabetes. Nutr Metab Cardiovasc Dis. 2010;20:474-80.

Park K. Park's textbook of preventive and social medicine. 18th Ed. Jabalpur: Banarasi Das Bhanot Publishers; 2005:1-2.

Boras J, Brkljačić N, Ljubičić A, Ljubić S. Silent ischemia and diabetes mellitus. Diabetol Croatica. 2010 Jun 1;39(2).

Yoo WS, Kim HJ, Kim D, Lee MY, Chung HK. Early detection of asymptomatic coronary artery disease in patients with type 2 diabetes mellitus. Korean J Int Med. 2009 Sep;24(3):183.

Sarkar NC, Jain S, Sarkar P, Tilkar M, Modi N. Early detection of coronary artery disease in asymptomatic type 2 diabetes mellitus patients. Inter J Adv Med. 2017 Feb 10;2(1):26-9.

Gupta SB, Pandit RB. Silent myocardial ischemia and cardiac autonomic neuropathy I diabetes. Ind Heart J. 1993;44(4):227-9.

Sargin H, Ozisik M, Oxisik NC, Seven O, Orbay E, Gozu H, et al. The prevalence of silent ischemia in Turkish patients with type 2 diabetes mellitus. Tohoku J Exp Med. 2005;20594:351-5.

Fuster V, Alexander WR, Rourke RAO. Hurst's The Heart. 11th Edition, Vol 1. New Delhi: McGraw Hill Medical Publishing; 2004:2081-2096.

Tandon R, Bajpai HS. A comprehensive study of autonomic dysfunction in diabetes. JAPI. 1985;33:265-8.