Prevalence of Coronary Risk Factors in Type 2 Diabetics without Manifestations of Overt Coronary Heart Disease.

ABSTRACT

Aims: To find the prevalence of cardiovascular risk factors in type-2 diabetics without manifestations of overt coronary heart disease and to estimate the prevalence of silent myocardial ischaemia in these patients. Methods: Seventy seven patients of type 2 diabetes were recruited for the study (one patient lost after recruitment; 76 completed the study). History and physical examination were recorded. Laboratory investigations included fasting and 2-hour post-prandial blood sugar, blood urea, serum creatinine, lipid profile, glycated haemoglobin, and microalbuminuria. Ultrasonographic scanning of the carotid arteries was performed to measure the carotid IMT. For identification of cases of silent ischaemia, treadmill test (TMT) was performed. Results: The study group was divided into a non-CAD group (n=54), and a silent CAD group (n=22). Twenty-two diabetics were found to have silent CAD as evidenced by a positive TMT result (28.9%). The prevalence of silent myocardial ischaemia was almost similar in both males and females. Serum LDL levels more than 140 mg% had a significant correlation with the prevalence of silent CAD (p=0.04). The difference in CCA-IMT values was found to be statistically significant between the silent CAD and non-CAD groups (p=0.019). Conclusion: High LDL level and greater carotid intima-media thickness are particularly important parameters that can predict if a patient of type 2 diabetes is at risk for silent ischaemia. A high carotid IMT is a surrogate and reliable marker of higher risk of CAD amongst type 2 diabetic patients, even in those without overt CAD. The study also underlines the utility of carotid IMT as a simple, non-invasive, safe, and cheap screening test for the assessment of risk of CAD in type 2 diabetics. ©