Presence of asymptomatic coronary artery disease in type 2 diabetes mellitus and risk factors

Abstract

Background: “Coronary artery disease (CAD) remains a significant cause of morbidity and mortality, particularly among individuals with type 2 diabetes mellitus (T2DM). Diabetic patients are at a higher risk of developing CAD, often presenting asymptomatically. Despite the global burden of CAD, limited studies exist on its prevalence among asymptomatic T2DM patients in the Indian population. This study aims to determine the proportion of asymptomatic CAD in patients with T2DM and identify associated risk factors.

Materials and Methods: A cross-sectional study was conducted at BLDE (DU) Shri B.M Patil Medical College Hospital and Research Centre between May 2023 and December 2024. 105 T2DM patients (aged 40-60 years, with diabetes for over five years) were included. Data collection involved detailed history, clinical examination, BMI assessment, and investigations such as electrocardiography (ECG), 2D echocardiography, lipid profile, treadmill test (TMT), and coronary angiography. Statistical analysis included descriptive and inferential statistics, with a p-value of <0.05 considered significant.”

Results: CAD was detected in 53.3% of patients. The mean patient age was 52.46 ± 5.63 years, with a slight male predominance (60%). Smoking was significantly higher among CAD-positive patients (82.1%) compared to CAD-negative patients (55.2%) (p<0.05). CAD-positive individuals had significantly higher mean BMI, HbA1c, total cholesterol, triglycerides, and LDL cholesterol, along with lower HDL levels, indicating dyslipidemia as a critical risk factor. Triple-vessel disease (TVD) was the most common pattern, affecting 22.9% of cases.

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Conclusion: The study highlights the substantial burden of asymptomatic CAD among T2DM patients, emphasising the need for early screening and intervention. Strict glycemic control, lifestyle modifications, and aggressive management of dyslipidemia and smoking cessation should be prioritised to mitigate cardiovascular risks. Future research should focus on cost-effective screening tools to enhance early detection and improve patient outcomes.