A Non-Interventional, Multicenter, Observational Study to Provide Real World Evidence on the Diagnosis of Chronic Coronary Syndrome In Patients With Diabetes Mellitus In Greece - The CONTACT STUDY

AIMS: Long-standing type 2 diabetes mellitus (DM) increases the risk of chronic coronary syndrome (CCS). We estimated the prevalence of undiagnosed CCS during routine outpatient care and described diagnostic testing strategies. METHODS: This multicenter observational study was conducted in eight diabetes and cardiology outpatient clinics in Greece. Adults with DM ≥10 years and suspected ischemia [angina equivalents and/or ischemic electrocardiographic (ECG) abnormalities] without known CCS underwent joint diabetologist-cardiologist evaluation and appropriate non-invasive and/or invasive testing at physician discretion. RESULTS: Overall, 110 people with type 2 DM (mean age 65.4 years; 47.3% women; mean DM duration 21.3 years) were evaluated. CCS was diagnosed in 15 individuals (13.6%). No patient with CCS reported typical or atypical angina; presentations were mainly angina equivalents, most commonly fatigue (66.7%) and dyspnea (58.3%). Ischemic ECG abnormalities were present in 6/15 (40.0%), including repolarization or conduction changes. Initial tests varied: exercise ECG (33.6%), SPECT/PET (32.7%), and stress echocardiography (28.2%). CONCLUSIONS: This study highlights the diagnostic complexity of detecting CCS in individuals with type 2 DM, particularly due to the prevalence of non-classical symptoms. The findings underscore the importance of a personalized diagnostic approach and multidisciplinary collaboration between diabetologists and cardiologists, to improve cardiovascular risk stratification.