Myocardial ischemia, carotid, and peripheral arterial disease and their interrelationship in type 2 diabetes patients.
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.
Poulsen
Mikael K
MK
Department of Endocrinology, Odense University Hospital, Kløvervaenget 6, 5th Floor, 5000, Odense C, Denmark. doc_mkp@hotmail.com
Henriksen
Jan Erik
JE
Dahl
Jordi
J
Johansen
Allan
A
Møller
Jacob E
JE
Gerke
Oke
O
Vach
Werner
W
Haghfelt
Torben
T
Beck-Nielsen
Henning
H
Høilund-Carlsen
Poul Flemming
PF
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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