7. Prevalence of CAD in asymptomatic type II diabetics, using MPI as screening tool. Single center cross sectional study from KSA

Abstract

Clinical research. Presentation Type: Oral presentation. Introduction: In patients with type 2 diabetes coronary artery disease (CAD) is a major cause of mortality and morbidity. Knowing the elevated risk of cardiovascular events and high prevalence of silent myocardial ischemia, screening asymptomatic diabetic patients-yet controversial-is appealing. The aim of the study is to measure the prevalence of silent ischemia in asymptomatic type-II diabetic patient with at least one or more of the given risk factors i.e. Hypertension, Dyslipidemia, Smoking, obesity and F/H of CAD. Myocardial perfusion Imaging is a sensitive test to look for myocardial ischemia. Methodology: This is a single center cross sectional study, approved by the institutional review board of the hospital. The study subjects were type-II diabetes of >5 years duration, asymptomatic, having one or more of the risk factors; The subjects were screened for CAD using myocardial perfusion imaging (MPI). Further intervention or treatment was left to primary physician in case of positive results. Results: A total of 137 patients-after obtaining an informed consent-underwent MPI. There were no complications during the tests. All of the patients tolerated the test well. ECGs were obtained. Two independent reviewers (blinded to each other’s findings) reviewed tests. A test was considered ”Positive” only if both reviewers results matched (in distribution, severity and size). Of 137 cohort, 21(15%) showed perfusion defects consistent with significant myocardial ischemia in a specific coronary artery distribution. Average sum stress score (SSS) was 5 (range 4–8, mode 4). Of the whole group, patients with higher HbA1C had the positive MPI. Results of positive patients were relayed to their primary physicians. Conclusion: Despite higher rate of diabetes in Saudi Arabia, asymptomatic Diabetics have a lower than expected incidence of active CAD. There would be a need to test this notion further. This would require more studies to confirm our findings in Saudi population.