Silent Myocardial Ischemia (SMI) and its Association with Microalbuminuria in Type 2 Diabetes Mellitus (DM)

Abstract

Background: As silent myocardial ischemia (SMI) is more common in diabetic population leading to the development of future coronary artery disease (CAD), so its early diagnosis is important. SMI can be diagnosed by conventional cardiac stress testing. Presence of SMI can also be suspected by microalbuminuria (MAU) because recently it is claimed that MAU is one of the important predictor for cardiovascular disease. Objective: The study was designed to explore the association between SMI & MAU in type 2 DM. Methods: It was a cross sectional study carried out in the Department of Biochemistry, BSMMU during the period of July 2006 to June 2008. One hundred diagnosed type 2 DM patients were selected from out patient department of BIRDEM. Enrolled study subjects were advised to do ETT and then categorized as ETT +ve & ETT-ve on the basis of ETT findings. Urinary micro albumin was measured in all study subjects. Unpaired t test, , chi square test, odds ratio were used to see the level of significance Results: Among the 100 type 2 diabetic subjects of both sexes 50 (male -24, female- 26) were ETT +ve designated as type 2 DM with silent MI and rest 50 ( male- 25 , female-25) were ETT ve designated as type 2 DM without silent MI. 21 patients (42%) out of 50 type 2 DM with silent MI & 16 patients (32%) out of 50 type 2 DM without silent MI found to have microalbuminuria. Calculated odds ratio was 1.5. Conclusion: Microalbuminuria is a possible risk factor for SMI in type 2 DM. Urinary micro albumin can be used particularly as a screening test for early detection of SMI.

DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.11016

BSMMU J 2012; 5(1):42-45