title: Myocardial ischemia, carotid, and peripheral arterial disease and their interrelationship in type 2 diabetes patients.
abstract: BACKGROUND
  Cardiovascular disease (CVD) is the leading cause of death in type 2 diabetes mellitus (T2DM) patients. We examined the relationship between CVD in different vascular territories.
  
  
  METHODS
  T2DM patients without known or suspected CVD (n = 305) referred consecutively to a diabetes clinic for the first time and age-matched nondiabetic reference subjects (n = 40) were screened for myocardial ischemia, carotid, and peripheral arterial disease by means of myocardial perfusion scintigraphy, carotid artery ultrasonography, and peripheral ankle and toe systolic blood pressure measurements.
  
  
  RESULTS
  In the T2DM patients, the prevalence of myocardial ischemia, carotid, and peripheral arterial disease was 30%, 42%, and 15%, respectively, almost three times higher than in the reference subjects (P = 0.007, P = 0.001, and P = 0.09, respectively). T2DM patients with myocardial ischemia, carotid, or peripheral arterial disease had a significantly increased risk of CVD in other vascular territories as well (OR: 1.99, 2.09, and 3.09, respectively). However, 40%, 52%, and 22% of the T2DM patients with myocardial ischemia, carotid, or peripheral arterial disease demonstrated exclusively this particular type of CVD manifestation.
  
  
  CONCLUSIONS
  In T2DM patients, signs of CVD in one vascular territory carry a significantly increased risk of CVD in other territories, although many patients only presented one manifestation.
authors.affiliation: Department of Endocrinology, Odense University Hospital, Kløvervaenget 6, 5th Floor, 5000, Odense C, Denmark. doc_mkp@hotmail.com
authors.forename: Mikael K
authors.initials: MK
authors.lastname: Poulsen
authors.forename: Jan Erik
authors.initials: JE
authors.lastname: Henriksen
authors.forename: Jordi
authors.initials: J
authors.lastname: Dahl
authors.forename: Allan
authors.initials: A
authors.lastname: Johansen
authors.forename: Jacob E
authors.initials: JE
authors.lastname: Møller
authors.forename: Oke
authors.initials: O
authors.lastname: Gerke
authors.forename: Werner
authors.initials: W
authors.lastname: Vach
authors.forename: Torben
authors.initials: T
authors.lastname: Haghfelt
authors.forename: Henning
authors.initials: H
authors.lastname: Beck-Nielsen
authors.forename: Poul Flemming
authors.initials: PF
authors.lastname: Høilund-Carlsen
mesh_terms: D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D055414:Myocardial Perfusion Imaging / Q000706:statistics & numerical data; D016491:Peripheral Vascular Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
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