Key result
Diabetes mellitus was associated with a higher rate of ischemic heart disease diagnosis compared to non-diabetic patients (15% vs 6%, p=0.004) among primary care patients referred to cardiology.
Why the study?
Differences in cardiac symptoms, diagnostic test use, and clinical diagnoses between diabetic and non-diabetic primary care patients referred for cardiology evaluation were not well characterized.
Does diabetes status affect the presentation of cardiac symptoms and yield of diagnostic tests in primary care patients referred to cardiology?
Observational (n=704)
Does diabetes status affect the presentation of cardiac symptoms and yield of diagnostic tests in primary care patients referred to cardiology?
Absolute Event Rate: 15% vs 6%
p-value: p=0.004
Among primary care patients referred to cardiology, diabetic patients are more likely to present with chest pain and be diagnosed with ischemic heart disease, while non-diabetic patients more frequently present with and are diagnosed with arrhythmias.
Diabetics referred from primary care receive more ischemic heart disease diagnoses; leaves open whether symptom-guided testing strategies need refinement.
AIMS: To compare the symptoms, diagnostic tests used, and clinical diagnoses made among diabetic and non-diabetic patients. METHODS: This is a register-based study of 704 primary care patients referred electively to cardiology specialists in the city of Turku, Finland, during the year 2016. The patient's medical history, cardiovascular medication use, risk factors, cardiac symptoms, diagnostic tests applied, and diagnoses made were gathered from the medical records. The angiography data was derived from the Hospital District of Southwest Finland data pool. RESULTS: Of the cohort, 120 (17 %) patients had diabetes mellitus. They were on average older (67 vs. 63 years, p = 0.009) and more often females (62 % vs. 38 %, p = 0.042) than the non-diabetic patients. Chest pain or discomfort was the most prevalent symptom in the diabetic patients and a sense of arrhythmia in the non-diabetic subjects. Ischemic heart disease was diagnosed more often in the person with diabetes (15 %) than in the non-diabetic (6 %) patients (p = 0.004). Cardiac arrhythmias were diagnosed in 26 % of the non-diabetic and 20 % of the diabetic subjects (p = 0.021). CONCLUSIONS: Symptoms that might indicate heart disease, especially chest pain/discomfort, are common in both the diabetic and the non-diabetic patients in primary care. Several diagnostic tests are applied, possibly not to miss a life-threatening disease. However, many patients do not get a specific diagnosis for their concerns.
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Sundqvist et al. (2023) conducted an observational in Cardiac symptoms (n=704). Diabetes mellitus vs. Without diabetes was evaluated on Ischemic heart disease diagnosis (p=0.004). Diabetes mellitus was associated with a higher rate of ischemic heart disease diagnosis compared to non-diabetic patients (15% vs 6%, p=0.004) among primary care patients referred to cardiology.
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