Exercise Treadmill Test in Detecting Asymptomatic Coronary Artery Disease in Type 2 Diabetes Mellitus.
- Author:
Mee Kyoung KIM
1
;
Ki Hyun BAEK
;
Ki Ho SONG
;
Hyuk Sang KWON
;
Jung Min LEE
;
Moo Il KANG
;
Kun Ho YOON
;
Bong Yun CHA
;
Ho Young SON
;
Kwang Woo LEE
Author Information
- Publication Type:Original Article
- Keywords: Diabetes mellitus; Duration of diabetes; Exercise treadmill test; Silent myocardial ischemia
- MeSH: Aged; Chest Pain; Constriction, Pathologic; Coronary Angiography; Coronary Artery Disease; Coronary Stenosis; Coronary Vessels; Diabetes Mellitus; Diabetes Mellitus, Type 2; Dyspnea; Exercise Test; Humans; Mass Screening; Thorax
- From:Diabetes & Metabolism Journal 2011;35(1):34-40
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND: The present study was designed to develop criteria for screening patients with type 2 diabetes mellitus (T2DM) for asymptomatic coronary artery disease (CAD). METHODS: A total of 213 patients with T2DM without typical angina or chest pain were studied between 2002 and 2007. We also evaluated 53 patients with T2DM who had reported chest discomfort using an exercise treadmill test (ETT). RESULTS: Thirty-one of the 213 asymptomatic patients had positive ETT results. We performed coronary angiography on 23 of the 31 patients with a positive ETT and found that 11 of them had significant coronary stenosis. The main differences between the patients with significant stenosis and those with a negative ETT were age (63.1+/-9.4 vs. 53.7+/-10.1 years, P=0.008) and duration of diabetes (16.0+/-7.5 vs. 5.5+/-5.7 years, P<0.001). The positive predictive value (PPV) of the ETT was calculated to be 47.8%. The PPV of the ETT increased to 87.5% in elderly patients (> or =60 years) with a long duration of diabetes (> or =10 years). The latter value is similar to that of patients with T2DM who presented with chest discomfort or exertional dyspnea. The PPV of the ETT in symptomatic patients was 76.9%. CONCLUSION: In the interest of cost-effectiveness, screening for asymptomatic CAD could be limited to elderly patients with a duration of diabetes > or =10 years.
