SILENT MYOCARDIAL ISCHEMIA IN TYPE 2 DIABETIC PATIENTS WITH MICROALBUMINURIA

Background: Silent myocardial ischemia (SMI) is more prevalent in type 2 diabetes mellitus (T2DM) patients, resulting in worse cardiovascular outcomes in the future. Therefore, it's early and prompt diagnosis is the need of the hour. It can be identified by traditional cardiac stress testing such as exercise tolerance test. Presence of SMI can also be predicted by microalbuminuria as it can significantly forecast any future cardiovascular event. The objective of this study was to find out the frequency of SMI in T2DM patients with microalbuminuria.Materials & Methods: A cross-sectional survey was carried out at the Diabetes Research Centre Outpatients Clinic, Nishtar Hospital, Multan, 01/01/2020 to 30/06/2020. After taking informed consent, patients having T2DM and microalbuminuria were included. Every participant had to undergo exercise tolerance test (ETT). Patients were regarded as having SMI if they fulfilled Bruce protocol and had myocardial ischemia on stress ETT. All gathered data was analyzed using SPSS version 24. Mean and standard deviation was measured for age and duration of DM. Frequency and percentage was measured for gender and presence or absence of SMI as confirmed by ETT.Results: This study comprised of a total 81 patients. Mean age of patients was 49.72 & PLUSMN;6.75 years, with range of 30. Male patients were 49(60.5%) whereas 32(39.5%) were female. Mean duration of T2DM was 12.52 & PLUSMN;4.71 years. SMI was present in 34 (41.9%) T2DM patients with microalbuminuria, as confirmed by ETT. Among the positive cases, majority belonged to 51-60 years age group (50.0%) and most of them were males 20 (58.8%). The majority of patients aged more than 60 years had SMI (85.7%), detected by ETT.Conclusion: Frequency of SMI in the current study (41.9%) is startling and direct us for earlier diagnosis and management of T2DM and microalbuminuria to prevent any cardiovascular event. Screening with ETT should be done for SMI in every diabetic patient with microalbuminuria.

Automated summary

The frequency of silent myocardial ischemia (SMI) in type 2 diabetes mellitus (T2DM) patients with microalbuminuria was found to be 41.9% in this study, highlighting the importance of early diagnosis and management of T2DM and microalbuminuria to prevent cardiovascular events.