Bhatia Lovleen C, Singal Rikki, Jain Parul, Mishra Neha, Mehra Varoon
Department of Medicine, M.M. Institute of Medical Sciences and Research, Mullana, Ambala, India.
High Blood Press Cardiovasc Prev. 2012 Sep 1;19(3):137-42. doi: 10.1007/BF03262463.
Diabetic patients have an increased prevalence of atherosclerosis and coronary artery disease. They may also experience higher morbidity and mortality after acute coronary syndrome compared with non-diabetic subjects.
The objective of this study was to determine the presence of silent myocardial ischaemia by treadmill test in asymptomatic diabetic patients and to compare it with age- and sex-matched subjects without diabetes mellitus.
The study design was cross-sectional and the setting was a tertiary care centre. Fifty (42 males, 8 females) asymptomatic patients with diabetes in the age group of 30-70 years were included in the study group and 30 (24 males, 6 females) non-diabetic subjects of comparable age, sex and physical activity were the control group. They were assessed for the presence of silent ischaemia by a standard treadmill test using the Bruce protocol.
Twenty-five of 50 diabetic patients showed a positive response to the exercise stress test, while 7 of 30 controls showed stress test positivity (p < 0.05). The stress test positivity showed a female predilection among diabetic patients (50% in diabetic patients and 16.67% in controls; p < 0.05). Diabetic patients with a positive stress test showed higher prevalence of hypertension (36%) and dyslipidaemia (84%) compared with diabetic patients with a negative stress test (12% and 28%, respectively) [p < 0.001]. The controls showed a better exercise capacity compared with diabetic patients; diabetic patients with a negative stress test had better exercise capacity than those with a positive stress test.
The treadmill test is a useful, specific, cost-effective, non-invasive tool for detection of silent myocardial ischaemia in asymptomatic diabetic patients.
糖尿病患者动脉粥样硬化和冠状动脉疾病的患病率增加。与非糖尿病患者相比，他们在急性冠状动脉综合征后也可能经历更高的发病率和死亡率。
本研究的目的是通过跑步机试验确定无症状糖尿病患者是否存在无症状心肌缺血，并将其与年龄和性别匹配的非糖尿病患者进行比较。
研究设计为横断面研究，研究地点为三级医疗中心。研究组纳入了50名（42名男性，8名女性）年龄在30 - 70岁之间的无症状糖尿病患者以及30名（24名男性，6名女性）年龄、性别和体力活动相当的非糖尿病患者作为对照组。使用布鲁斯方案通过标准跑步机试验评估他们是否存在无症状缺血。
50名糖尿病患者中有25名对运动应激试验呈阳性反应，而30名对照组中有7名应激试验呈阳性（p < 0.05）。应激试验阳性在糖尿病患者中表现出女性偏好（糖尿病患者中为50%，对照组中为16.67%；p < 0.05）。与应激试验阴性的糖尿病患者（分别为12%和28%）相比，应激试验阳性的糖尿病患者高血压（36%）和血脂异常（84%）的患病率更高[p < 0.001]。与糖尿病患者相比，对照组的运动能力更好；应激试验阴性的糖尿病患者比阳性的糖尿病患者运动能力更好。
跑步机试验是检测无症状糖尿病患者无症状心肌缺血的一种有用、特异、经济有效且无创的工具。
