SIGNIFICANCE OF THE DUKE TREADMILL SCORE ON THE SEVERITY OF CORONARY ARTERY DISEASE IN PATIENTS WITH AND WITHOUT DIABETES
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Keywords
Coronary artery disease, Duke Treadmill score, Diabetic patients
Abstract
Background and Aim: The coronary artery disease risk stratification can be done with established clinical tool Duke Treadmill Score (DTS). The present study aimed to investigate the role of Duke Treadmill Score in predicting the severity of coronary artery disease in diabetic vs. non-diabetics.
Patients and Methods: This prospective study was conducted on 100 diabetic and 100 non-diabetic patients in the Cardiology Department of Tertiary Care Hospital of Pakistan from January 2020 to December 2022. All the diabetic patients with blood sugar level >126 mg/dL were enrolled. Standard Bruce protocol was used for measuring the exercise stress tests. ST-T changes, rate, and rhythm were monitored by an electrocardiogram (ECG). Exercise test was terminated based on chest pain, ST depression N3 mm, ventricular tachycardia, excessive increase (>230 mm Hg), and limiting symptoms (such as dyspnea and dizziness). Data analysis was done using SPSS version 27.
Results: The overall mean age of diabetic and non-diabetic was 58±9.6 years and 58±9.7 years respectively. There were 112 (56%) male and 88 (44%) female. Hypertension, current smoking, and Hypercholesterolemia were different risk factors found (64% vs. 44%), (15% vs. 20%), and (21% vs 26%) respectively. Survival free from congestive heart failure, cardiac death, and nonfatal myocardial infarction was 15%, 87%, and 52% respectively in low to high-risk diabetic patients and 19%, 90%, and 55% respectively in nondiabetics. Coronary angiography and secondary events were more in diabetic groups than non-diabetic during follow-up. The severity of coronary artery disease was assessed using DTS in both diabetics and non-diabetics.
Conclusion: The DTS alone is an effective method for detecting a significant coronary artery. The DTS is an accurate predictor of CAD. Based on clinical data, individuals should be treated for DTS group intermediate risk outcome using exercise tests.
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Muntaha Irshad
FCPS Resident, National Institute of Cardiovascular Diseases, Karachi - Pakistan
Komal Arzoo
Department of Obs & Gynae, Fatima Memorial Hospital, Lahore - Pakistan
Murad Baig
Paediatrics Department, Shaukat Khanum Hospital, Lahore - Pakistan
Ali Raza Sandhu
Incharge Medical Officer at BHU 376JB, Toba Tek.Singh - Pakistan
Zubia Begum
Lecturer, Ph.D (Fellow), M.Phil, Pharm-D, Department of Pharmacology, Faculty of Pharmacy, Jinnah University for Women, Karachi - Pakistan
Soban Abu Khifs
House Officer, Ayub Teaching Hospital, Abbottabad - Pakistan
Kamel J. K. Walwil
Royal College of Surgeons in Ireland - Medical University of Bahrain
Jumana Abdelrahman Diab
Royal College of Surgeons in Ireland - Medical University of Bahrain
Hosam Alazazzi
Royal College of Surgeons in Ireland - Medical University of Bahrain
Akashnath Kivalur Ganeshanath
Royal College of Surgeons in Ireland - Medical University of Bahrain
Saifullah Syed
Royal College of Surgeon in Ireland, Dublin - Ireland