Non-invasive assessment of peripheral arterial disease in asymptomatic diabetic patients: Whom should we screen?

ABSTRACT

Diabetes mellitus is a major risk factor for cardiovascular morbidity and mortality. This condition increases the risk of developing coronary, cerebrovascular and peripheral arterial disease [PAD] up to 4 fold. It has been reported that more than half of those with PAD are asymptomatic or have atypical symptoms. Peripheral arterial disease [PAD] increases the risk of heart attack, stroke, amputation and death, hence early identification and treatment are crucial. The aim of this work was to assess the value of non invasive imaging using echo-doppler technique to detect peripheral arterial disease in diabetic and non-diabetic Egyptians. This study was conducted on forty patients admitted to Cardiology Department, Alexandria University suffering from anginal chest pain for evaluation of their chest pain, they were divided into two groups - Twenty diabetics suffering from type II diabetes, and twenty non diabetics. The two groups are matched as regard age and sex, there is significant increase in serum cholesterol, triglycerides, carotid intimal thickness in diabetic group there is marked increase in Carfem index in diabetic group but with no significant difference in ankle brachial index. As regards coronary angiography, most of diabetic patients [85%] are suffering from multi-vessels coronary artery disease. Non invasive measurements of atherosclerosis [Carotid and Carfem index] are of significant evidence in diabetic patients. Carfem index is a major predictor of coronary artery in diabetic patients. The ankle brachial pressure index was less sensistive than intimal and medial thickness of carotid and femoral arteries in the detection of early stages of atherosclerosis