Treadmill Test to Detect Stress Induced Ischemic Heart Disease in Type 2 Diabetes Mellitus Patients Asymptomatic for CAD: A Hospital Based Cross-sectional Study in Rural Population of Central India

Type 2 diabetes mellitus (DM) has got a distinct association with coronary artery disease (CAD); and diabetic patients have 2-4 fold higher risk of developing CAD than people without DM [1]. However, progressive coronary artery disease remains asymptomatic in many cases of type 2 diabetes and this makes diagnosis difficult at proper time [2]. Routine screening of type 2 diabetics for asymptomatic coronary artery disease with ECG remains controversial, as majority of them present with normal ECG [3]. Many studies have been published showing relationship between DM and silent ischemia; but there are hardly any studies targeting rural population, especially from Central India, where the demographics is totally different than urban settings. We present here a study showing relationship between type 2 DM and silent ischemia in patients representing this population, arriving in a tertiary health care hospital located in the outskirts of Nagpur, India. The interest here is to determine the proportion of silent ischemia in patients having type 2 DM, who are asymptomatic for CAD and have normal resting ECG and 2D Echo using TMT. Moreover, the interest is to determine the predictors of silent ischemia in such study population who underwent TMT.