Volume : VII, Issue : VIII, August - 2017

A STUDY OF EXERCISE TREADMILL TEST IN DETECTING ASYMPTOMATIC CORONARY ARTERY DISEASE IN TYPE 2 DIABETES MELLITUS

Paul Joy Pazhampillil, Sundaraj Ravindran, Prasannan Gokul

Abstract :

 INTRODUCTION: Patients with type2 DM show a greater risk for CAD. But the risk stratification in asymptomatic CAD patients has not been established. This study investigated the prevalence of CAD in type2 DM patients since CAD accounts for 70–80 % of mortalities in diabetic patients. CAD risk for those with type2 DM is as great as that associated with a previous history of MI. However progressive CAD is asymptomatic in many cases of type 2 DM ,which is difficult to diagnose at proper time.The diagnosis of

asymptomatic CAD in type 2 diabetic patients is largely made based on the recommendations of ADA.The ADA recommends tat DM patients perform a treadmill exercise test(TMT) if they have additional cardio vascular risk factors.how ever clinically significant severe CAD is often discovered in patients with fewer risk factors

 

AIMS AND OBJECTIVES:

1. To assess the prevalence of coronary artery disease in type 2 diabetes

without hyper tension with normal ECG &normal echo

2. To improve the long term survival of type 2 diabetic patients by

early detection of coronary artery disease and timely institution of

Treatment

 

MATERIALS&METHODS:

The study was conducted among out patients

from diabetology & cardiology departments of Government Rajaji Hospital,

Madurai during the period of January 2016 to June 2016. The study included

100 diabetic patients who had no previous symptoms of any cardiac disease.

Subjects believed to fulfill all eligibility criteria, and none of the exclusion

criteria were included in the study.

 

METHODOLOGY:

A previously designed proforma is used to collect the

demographic data ,history and clinical details of the patients.

A battery of diabetic profile tests are done in all cases to assess glycemic

status . 12 lead ECG is taken to all patients .Those who are showing normal

results are subjected to ECHO. If they show normal observation they will be

subjected to exercise induced treadmill test in all patients for half an hour. Any

exercise induced ischemia, MI, LBBB, any arrhythmias, are observed from the

ECG which is recorded. Comparisons of inducible ischemia in blood sugar

levels of fasting, Hba1c, BMI, ppbs are observed. Significance assessed by

Students t test. Relation between age, sex, and duration of diabetes are assessed

by Pearson correlation test.

 

STATISTICAL ANALYSIS:

STUDENTS T TEST, PEARSON CORRELATION TEST, ONE WAY ANOVA ,CHI SQUARE TEST

 

RESULTS:

The average age for study group was 54.92 years. Among the 100

patients studied 60 were males and 40 females . Among the cases studied 40

had inducible ischemia .Of these 40, 23 having 5–10 years duration of diabetes

,9 cases having more than 10 years of diabetes. Rate of inducible ischemia was

high in patients with high fasting, high BMI, high HbA1C compared to

patients with good glycaemic controls patients .Among the cases rate of

occurrence of ischemia was higher in those with poor glycaemic control than

with good glycemic control .Occurrence of ischemia significantly high in

patients even they are not having any symptoms of cardiac diseases. Based on

TMT results we can observe that CAD risk is high even at the age of 40 and rate

of ischemia occurrence is high if good glycemic control is not maintained.

 

CONCLUSION:

Type 2 diabetic patients are more prone for CAD since it is a coronary equalent.

Hence all diabetics after the age of 40 should be subjected to TMT as a

screening tool to diagnose early CAD .

 

Keywords :

Article: Download PDF   DOI : 10.36106/ijar  

Cite This Article:

Paul Joy Pazhampillil, Sundaraj Ravindran, Prasannan Gokul, A STUDY OF EXERCISE TREADMILL TEST IN DETECTING ASYMPTOMATIC CORONARY ARTERY DISEASE IN TYPE 2 DIABETES MELLITUS, INDIAN JOURNAL OF APPLIED RESEARCH : Volume‾7 | Issue‾8 | August‾2017

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