Silent myocardial ischaemia and risk factors in a diabetic Afro-Caribbean population

• Published in: Diabetes & metabolism 2011-12, Vol.37 (6), p.533-539
• Main Authors: Blanchet Deverly, A, Amara, M, Larifla, L, Velayoudom-Céphise, F.L, Roques, F, Kangambega, P, Hue, K, Foucan, L
• Format: Article
• Language: English
• Subjects: Afro-Caribéens; Antilles françaises; Antécédents cardiovasculaires; Biological and medical sciences; Cardiology. Vascular system; Coronary Angiography; Coronary heart disease; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 1 - complications; Diabetes Mellitus, Type 1 - diagnosis; Diabetes Mellitus, Type 1 - epidemiology; Diabetes Mellitus, Type 2 - complications; Diabetes Mellitus, Type 2 - diagnosis; Diabetes Mellitus, Type 2 - epidemiology; Diabetes. Impaired glucose tolerance; Diabetic Angiopathies - diagnosis; Diabetic Angiopathies - epidemiology; Diabetic Angiopathies - etiology; Diabète; Electrocardiography; Endocrine pancreas. Apud cells (diseases); Endocrinology & Metabolism; Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Exercise Test; Female; Guadeloupe - epidemiology; Heart; History of cardiovascular disease; Humans; Hypertrophie ventriculaire gauche; Internal Medicine; Ischémie myocardique silencieuse; Left ventricular hypertrophy; Male; Mass Screening; Medical sciences; Middle Aged; Myocardial Ischemia - diagnosis; Myocardial Ischemia - epidemiology; Myocardial Ischemia - etiology; Myocarditis. Cardiomyopathies; Prevalence; Risk Factors; Silent myocardial ischaemia
• ISSN: 1262-3636; 1878-1780
• DOI: 10.1016/j.diabet.2011.05.006

Abstract Aims In Guadeloupe, an island in the French West Indies, diabetes has a prevalence recently reported to be 10%. Myocardial ischaemia is more frequently silent in diabetics, and needs to be screened for and monitored, once identified. This study aimed to evaluate the prevalence of silent myocardial ischaemia (SMI) in a diabetic population and to analyze its associated cardiovascular risk (CVR) factors. Methods This was a cross-sectional study of 147 patients with associated CVR factors, defined according to the 2004 SFC/ALFEDIAM guidelines. Exercise stress tests, myocardial performance imaging and stress echocardiography were performed. Ancova and logistic regression were used in the statistical analyses. Results The patients’ mean age was 62 years, and 53% were male. Mean duration of diabetes was 14 years. Overall, 23.1% had SMI, and these patients more frequently had a personal history of cardiovascular disease vs those without SMI. On multivariate logistic-regression analyses, the adjusted odds ratios of SMI were significantly increased in patients with a personal history of cardiovascular disease (4.36, 95% CI: 1.36–13.96; P = 0.01) and left ventricular hypertrophy (LVH) (2.46, 95% CI: 1.03–5.86; P = 0.04). Conclusion The prevalence of SMI in our Afro-Caribbean diabetic population was 23.1%. Searching for a personal history of cardiovascular disease and LVH may help to identify patients who need to be screened for SMI.