Key result
Echocardiogram parameters did not predict suggestive coronary artery disease in asymptomatic patients with type 2 diabetes, though serum triglycerides ≥ 184.5 mg/dl were associated with increased risk.
Why the study?
Cardiovascular disease is a major cause of mortality and morbidity in diabetes mellitus, but echocardiographic alterations in T2DM patients with suggestive coronary artery disease remained to be assessed.
Does echocardiogram predict suggestive coronary artery disease in asymptomatic patients with type 2 diabetes mellitus?
Cross-Sectional (n=152)
No
Does echocardiogram predict suggestive coronary artery disease in asymptomatic patients with type 2 diabetes mellitus?
Routine echocardiographic parameters do not predict ECG-suggestive coronary artery disease in asymptomatic patients with type 2 diabetes, whereas hypertriglyceridemia and diabetic retinopathy are associated with CAD risk.
Echocardiography should not guide CAD screening in asymptomatic T2DM; cross-sectional data leave triglyceride thresholds open for prospective validation.
BACKGROUND: Patients with diabetes mellitus (DM) have cardiovascular diseases (CVD) as a major cause of mortality and morbidity. The primary purpose of this study was to assess the echocardiographic parameters that showed alterations in patients with type 2 diabetes mellitus(T2DM) with suggestive coronary artery disease (CAD) determined by electrocardiography and the secondary was to assess the relationship of these alterations with established cardiovascular risk factors. METHODS: This cross-sectional, observational pilot study included 152 consecutive patients with T2DM who attended a tertiary DM outpatient care center. All patients underwent clinical examination and history, anthropometric measurements, demographic survey, determination of the Framingham global risk score, laboratory evaluation, basal electrocardiogram, echocardiogram, and measurement of carotid intima-media thickness (CIMT). RESULTS: From the overall sample, 134 (88.1%) patients underwent an electrocardiogram. They were divided into two groups: patients with electrocardiograms suggestive of CAD (n = 11 [8.2%]) and those with normal or non-ischemic alterations on electrocardiogram (n = 123 [91.79%]). In the hierarchical multivariable logistic model examining all selected independent factors that entered into the model, sex, high triglycerides levels, and presence of diabetic retinopathy were associated with CAD in the final model. No echocardiographic parameters were significant in multivariate analysis. The level of serum triglycerides (threshold) related to an increased risk of CAD was ≥ 184.5 mg/dl (AUC = 0.70, 95% IC [0.51-0.890]; p = 0.026. CONCLUSION: Our pilot study demonstrated that no echocardiogram parameters could predict or determine CAD. The combination of CIMT and Framingham risk score is ideal to determine risk factors in asymptomatic patients with T2DM. Patients with diabetic retinopathy and hypertriglyceridemia need further investigation for CAD. Further prospective studies with larger sample sizes are needed to confirm our results.
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Palma et al. (2023) conducted a cross-sectional in Type 2 diabetes mellitus (n=152). Echocardiogram vs. Normal or non-ischemic electrocardiogram was evaluated on Echocardiographic parameters associated with suggestive coronary artery disease. Echocardiogram parameters did not predict suggestive coronary artery disease in asymptomatic patients with type 2 diabetes, though serum triglycerides ≥ 184.5 mg/dl were associated with increased risk.
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