Screening for asymptomatic cardiovascular disease in Arab patients with diabetes.
OBJECTIVE
Diabetes mellitus is a major risk factor for atherosclerosis and accordingly increased morbidity and mortality. This study aimed at screening high risk diabetic patients for atherosclerosis in different arterial territories.


METHODS
All high risk asymptomatic patients attending the diabetic clinic, King Fahd Hospital of the University, Saudi Arabia were invited to be screened for peripheral arterial disease (PAD), extra-cranial cerebrovascular disease (CVD) and coronary artery disease (CAD) over one year. All participants underwent measurement of ankle brachial pressure index, carotid Duplex scan and exercise electrocardiography (ECG). All patients underwent evaluation of conventional risk factors for atherosclerosis


RESULTS
One hundred and sixty nine patients were invited to be screened. Of these 138 (82%) completed all the screening tests. The mean age was 53.5±7.18 years. Seventy-five (55%) had evidence of subclinical atherosclerosis. In the atherosclerotic group, 24 patients had PAD, 47 had CVD and 30 had CAD. There were significant differences between the atherosclerotic and non-atherosclerotic groups with regard to most risk factors. In age, sex adjusted, the risk of developing atherosclerosis was significantly increased with all risk factors. Dyslipidemia had the highest association (OR 9.7, 95% CI 8.1-10.2)


CONCLUSIONS
Participation and diagnostic yield of screening for atherosclerosis had satisfactory validity and reliability. Routine screening in high-risk diabetic patients can serve as an effective tool for diagnosis of sub clinical cardiovascular disease and provide strategies to optimize risk reduction.
Department of Surgery, King Faisal University, Al-Khobar, Kingdom of Saudi Arabia. elsharawya@yahoo.co.uk
M A
MA
Elsharawy
A H
AH
Al-Elq
A H
AH
Alkhadra
K M
KM
Moghazy
A S
AS
Elsaid
D055109:Ankle Brachial Index; D018912:Arabs / Q000706:statistics & numerical data*; D058070:Asymptomatic Diseases; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000208:ethnology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis / Q000208:ethnology; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000208:ethnology; D003920:Diabetes Mellitus / Q000208:ethnology*; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000208:ethnology; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D018616:Ultrasonography, Doppler, Duplex