Ghent University Academic Bibliography

Advanced

Screening for silent myocardial ischaemia in patients with type 2 diabetes mellitus: a quest to improve selection of the target screening population

Eva De Keyzer, Dirk Kerkhove, Guy Van Camp, Johan De Sutter UGent, Wim Achtergael, Bart Keymeulen and Caroline Weytjens (2011) ACTA CARDIOLOGICA. 66(6). p.715-720
abstract
Objective Despite the association of diabetes mellitus type 2 (DM2) with silent myocardial ischaemia (SMI) and a high prevalence of death due to coronary artery disease (CAD), screening for CAD in patients with DM2 remains controversial because of a lack of proof that it improves cardiac outcome. The aim of this study was to improve the diagnostic yield of the exercise stress test (EST) by introducing recently published life expectancy tables in selecting DM2 patients for coronary screening. Methods 359 patients with DM2 without history or symptoms of CAD were included to perform an EST after a clinical history and brief physical examination. Cardiovascular risk factor profiling was completed with blood and urine analysis. A lower heart rate was defined as bradycardia (heart rate less than 60 bpm), a higher blood pressure as a systolic blood pressure at rest of 130 mmHg of more. Results The prevalence of SMI was 14.5% (n = 52). The average number of additional cardiovascular risk factors per subject was 4. Multivariate logistic regression yields 4 significant predictors: (i) heart rate at rest (P=0.015), (ii) a family history of cardiovascular disease (P= 0.017), (iii) systolic blood pressure at rest (P = 0.019), and, (iv) an LDL-c of 80 mg/dL or more (P = 0.021). Conclusion Known risk factors for myocardial ischaemia were identified as significantly influencing the prevalence of SMI. No improvement in diagnostic yield could be identified by selecting the screening population using predicted life expectancy tables.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
silent ischaemia, CORONARY-ARTERY-DISEASE, exercise, screening, Diabetes mellitus, CARDIOVASCULAR AUTONOMIC NEUROPATHY, HEART-DISEASE, RISK, ASSOCIATION, PREVALENCE, MORTALITY, PEOPLE, DIAD
journal title
ACTA CARDIOLOGICA
Acta Cardiol.
volume
66
issue
6
pages
715 - 720
Web of Science type
Article
Web of Science id
000298836300005
JCR category
CARDIAC & CARDIOVASCULAR SYSTEMS
JCR impact factor
0.605 (2011)
JCR rank
107/117 (2011)
JCR quartile
4 (2011)
ISSN
0001-5385
DOI
10.2143/AC.66.6.2136954
language
English
UGent publication?
no
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
2015340
handle
http://hdl.handle.net/1854/LU-2015340
date created
2012-02-02 09:37:42
date last changed
2012-02-02 15:26:14
@article{2015340,
  abstract     = {Objective Despite the association of diabetes mellitus type 2 (DM2) with silent myocardial ischaemia (SMI) and a high prevalence of death due to coronary artery disease (CAD), screening for CAD in patients with DM2 remains controversial because of a lack of proof that it improves cardiac outcome. The aim of this study was to improve the diagnostic yield of the exercise stress test (EST) by introducing recently published life expectancy tables in selecting DM2 patients for coronary screening. 
Methods 359 patients with DM2 without history or symptoms of CAD were included to perform an EST after a clinical history and brief physical examination. Cardiovascular risk factor profiling was completed with blood and urine analysis. A lower heart rate was defined as bradycardia (heart rate less than 60 bpm), a higher blood pressure as a systolic blood pressure at rest of 130 mmHg of more. 
Results The prevalence of SMI was 14.5\% (n = 52). The average number of additional cardiovascular risk factors per subject was 4. Multivariate logistic regression yields 4 significant predictors: (i) heart rate at rest (P=0.015), (ii) a family history of cardiovascular disease (P= 0.017), (iii) systolic blood pressure at rest (P = 0.019), and, (iv) an LDL-c of 80 mg/dL or more (P = 0.021). 
Conclusion Known risk factors for myocardial ischaemia were identified as significantly influencing the prevalence of SMI. No improvement in diagnostic yield could be identified by selecting the screening population using predicted life expectancy tables.},
  author       = {De Keyzer, Eva and Kerkhove, Dirk and Van Camp, Guy and De Sutter, Johan and Achtergael, Wim and Keymeulen, Bart and Weytjens, Caroline},
  issn         = {0001-5385},
  journal      = {ACTA CARDIOLOGICA},
  keyword      = {silent ischaemia,CORONARY-ARTERY-DISEASE,exercise,screening,Diabetes mellitus,CARDIOVASCULAR AUTONOMIC NEUROPATHY,HEART-DISEASE,RISK,ASSOCIATION,PREVALENCE,MORTALITY,PEOPLE,DIAD},
  language     = {eng},
  number       = {6},
  pages        = {715--720},
  title        = {Screening for silent myocardial ischaemia in patients with type 2 diabetes mellitus: a quest to improve selection of the target screening population},
  url          = {http://dx.doi.org/10.2143/AC.66.6.2136954},
  volume       = {66},
  year         = {2011},
}

Chicago
De Keyzer, Eva, Dirk Kerkhove, Guy Van Camp, Johan De Sutter, Wim Achtergael, Bart Keymeulen, and Caroline Weytjens. 2011. “Screening for Silent Myocardial Ischaemia in Patients with Type 2 Diabetes Mellitus: a Quest to Improve Selection of the Target Screening Population.” Acta Cardiologica 66 (6): 715–720.
APA
De Keyzer, E., Kerkhove, D., Van Camp, G., De Sutter, J., Achtergael, W., Keymeulen, B., & Weytjens, C. (2011). Screening for silent myocardial ischaemia in patients with type 2 diabetes mellitus: a quest to improve selection of the target screening population. ACTA CARDIOLOGICA, 66(6), 715–720.
Vancouver
1.
De Keyzer E, Kerkhove D, Van Camp G, De Sutter J, Achtergael W, Keymeulen B, et al. Screening for silent myocardial ischaemia in patients with type 2 diabetes mellitus: a quest to improve selection of the target screening population. ACTA CARDIOLOGICA. 2011;66(6):715–20.
MLA
De Keyzer, Eva, Dirk Kerkhove, Guy Van Camp, et al. “Screening for Silent Myocardial Ischaemia in Patients with Type 2 Diabetes Mellitus: a Quest to Improve Selection of the Target Screening Population.” ACTA CARDIOLOGICA 66.6 (2011): 715–720. Print.