Hyun-Kyung Chung

Early detection of asymptomatic coronary artery disease in patients with type 2 diabetes mellitus.

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 ≥2, group B ≤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 ≥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 (≥10 years) diabetic duration or a family history of CAD, even if they are asymptomatic for CAD.