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Research Article Open access CC BY 4.0

Role of Hs-CRP and Exercise Stress Echocardiography in Cardiovascular Risk Stratification of Asymptomatic Type 2 Diabetic Patients

Puneet Aggarwal, Tilak Raj Khurana, Ranjeet Nath, Swati Yadav

Cardiology and Angiology: An International Journal · pp. 139–146 · Published 29 Oct 2015

10.9734/CA/2015/19495

Abstract

Background: Silent ischaemia is a well known cause of mortality and morbidity in type-2 diabetic patients; however the role of high-sensitive C-Reactive Protein (hs-CRP) and exercise stress echocardiography in early detection of silent ischaemia is still less understood. Methods: Seventy three asymptomatic diabetic patients were enrolled from Dr Ram Manohar Lohia Hospital, Delhi in year 2013-15 and the baseline characteristics of the patients were studied. All the patients underwent exercise stress echocardiography for screening of coronary artery disease (CAD). All the patients with positive exercise stress echocardiography underwent angiography for confirmation of coronary artery disease. The patients were divided into two groups on basis of exercise stress echocardiography result as positive and negative and the baseline characteristics and risk factors including high-sensitivity C-reactive protein (hs-CRP) concentrations were compared between two groups in cross sectional study. Results: Silent ischaemia was found in 17.81% in asymptomatic diabetic patients. The positive predictive value of exercise stress echocardiography taking angiography as gold standard was found to be 84.6%. Sensitivity of hs-CRP >3 mg/L in predicting a positive exercise stress echocardiography is 53.8% and specificity is 90%. Negative predictive value of hs-CRP ≤3 mg/L in ruling out CAD is 90.0% and positive predictive value in detecting positive exercise stress echocardiography was 53.8%. Positive exercise stress echocardiography was found to be significantly associated with hypertension (HTN) (P=0.048), smoking (P=0.018), family history of CAD (P=0.002), total cholesterol (P=0.031), serum low-density lipoprotein (LDL) concentrations (P=0.041), serum hs-CRP (P=0.001), strict glycaemic control (glycated haemoglobin <7%) (P=0.028) and final ejection fraction after exercise stress (P=0.01). Conclusion: hs-CRP and exercise stress echocardiography can be used as simple screening tool for coronary artery disease in asymptomatic diabetic patients.  

Diabetes stress echocardiography hs CRP silent ischaemia

References (11)

  1. 1 Prognostic value of exercise echocardiographyin 5,798 patients: is there a gender difference? [DOI]
  2. 2 Use of Exercise Echocardiography for Prognostic Evaluation of Patients With Known or Suspected Coronary Artery Disease fn1fn1This study would not have been possible without the support of the sonographers, fellows and staff of the Echocardiography Laboratory of the Cleveland Clinic Foundation. [DOI]
  3. 3 Prognostic stratification of diabetic patients by exercise echocardiography [DOI]
  4. 4 Evaluation of the patient with diabetes mellitus and suspected coronary artery disease [DOI]
  5. 5 Effect of prior myocardial infarction and extent and location of coronary disease on accuracy of exercise echocardiography [DOI]
  6. 6 Exercise echocardiography as a screening test for coronary artery disease and correlation with coronary arteriography [DOI]
  7. 7 Noninvasive Screening for Coronary Atherosclerosis and Silent Ischemia in Asymptomatic Type 2 Diabetic Patients [DOI]
  8. 8 Novel stress echocardiographic model incorporating the extent and severity of wall motion abnormality for risk stratification and prognosis [DOI]
  9. 9 Prognostic Value of Exercise Echocardiography in Patients With Diabetes Mellitus and Known or Suspected Coronary Artery Disease [DOI]
  10. 10 Silent myocardial ischemia and infarction in diabetics with peripheral vascular disease: Assessment by dipyridamole thallium-201 scintigraphy [DOI]
  11. 11 Influence of left ventricular hypertrophy on detection of coronary artery disease using exercise echocardiography [DOI]

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