ABSTRACT
AIM: Diabetes mellitus is a major risk factor for atherosclerosis and accordingly increased morbidity and mortality. This study aimed at screening high risk diabetic patients for atherosclerosis in different arterial territories. METHODS: All high risk asymptomatic patients attending the diabetic clinic, King Fahd Hospital of the University, Saudi Arabia were invited to be screened for peripheral arterial disease (PAD), extra-cranial cerebrovascular disease (CVD) and coronary artery disease (CAD) over one year. All participants underwent measurement of ankle brachial pressure index, carotid Duplex scan and exercise electrocardiography (ECG). All patients underwent evaluation of conventional risk factors for atherosclerosis RESULTS: One hundred and sixty nine patients were invited to be screened. Of these 138 (82%) completed all the screening tests. The mean age was 53.5±7.18 years. Seventy-five (55%) had evidence of subclinical atherosclerosis. In the atherosclerotic group, 24 patients had PAD, 47 had CVD and 30 had CAD. There were significant differences between the atherosclerotic and non-atherosclerotic groups with regard to most risk factors. In age, sex adjusted, the risk of developing atherosclerosis was significantly increased with all risk factors. Dyslipidemia had the highest association (OR 9.7, 95% CI 8.1-10.2) CONCLUSION: Participation and diagnostic yield of screening for atherosclerosis had satisfactory validity and reliability. Routine screening in high-risk diabetic patients can serve as an effective tool for diagnosis of sub clinical cardiovascular disease and provide strategies to optimize risk reduction.
Subject(s)
Arabs/statistics & numerical data , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/ethnology , Diabetes Mellitus/ethnology , Mass Screening , Ankle Brachial Index , Asymptomatic Diseases , Cerebrovascular Disorders/diagnosis , Cerebrovascular Disorders/ethnology , Chi-Square Distribution , Coronary Artery Disease/diagnosis , Coronary Artery Disease/ethnology , Electrocardiography , Exercise Test , Female , Humans , Logistic Models , Male , Mass Screening/methods , Middle Aged , Odds Ratio , Peripheral Arterial Disease/diagnosis , Peripheral Arterial Disease/ethnology , Predictive Value of Tests , Prospective Studies , Risk Assessment , Risk Factors , Saudi Arabia/epidemiology , Ultrasonography, Doppler, DuplexABSTRACT
AIM: Although the risk factors for atherosclerosis have been identified, their impacts on the extent of arterial occlusive disease among Arabian population have never been studied before. METHODS: A case control study was undertaken on consecutive series of Arabian patients over one year. The study comprised 2 patients groups: atherosclerotic group which included patients aged 40 years and older admitted with peripheral, carotid or coronary artery disease and the control group, including patients admitted to one of the general surgical units who were free from atherosclerotic disease. All patients underwent evaluation of risk factors for atherosclerotic and systemic study of the vascular tree. Correlation and association were checked between prevalence of these factors and the extent of atherosclerotic disease into different territories. RESULTS: Two hundred and fifteen patients in the atherosclerotic group and 191 patients in the control group were included. The incidence of diabetes mellitus (DM) was very high in the atherosclerotic group (67.8%). There was significant correlation between incidence of risk factors and risk and extent of atherosclerosis. In age, sex and nationality-adjusted logistic regression analysis, combination of some risk factors augmented the risk and extent of atherosclerosis e.g. diabetes alone increased the risk of atherosclerosis slightly in one affected system (OR 2.28, 95% CI 1.9-2.7) while combination of diabetes, smoking and dyslipidemia enhanced this risk (OR 7.4, 95% CI 2.5-22.4). CONCLUSIONS: The risk factors of atherosclerosis increase its incidence and extent into different territories.
