Associations of asymptomatic coronary heart disease in a cohort of stable type 2 diabetic subjects in a tertiary health center in south eastern Nigeria: A cross sectional study
1 Department of Internal Medicine, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
2 Department of Nursing Sciences, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria.
3 Department of Internal Medicine, Enugu State University of Science and Technology, Enugu, Nigeria
4 Department of Internal Medicine, Abia State University Teaching Hospital, Aba, Nigeria.
5 Department of Internal Medicine, College of Medicine, Alex Ekwueme Federal University Ndufu Alike Ikwo, Ebonyi State, Nigeria.
6 Department of Internal Medicine, University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
7 Department of Ophthalmology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
8 Department of Internal Medicine, University of Nigeria Teaching Hospital, Enugu, Enugu State, Nigeria.
9 Department of Surgery, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
10 Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.
Research Article
International Journal of Scholarly Research in Multidisciplinary Studies, 2024, 04(01), 001–012.
Article DOI: 10.56781/ijsrms.2024.4.1.0090
Publication history:
Received on 05 November 2023; revised on 31 December 2023; accepted on 03 January 2024
Abstract:
Background: Coronary heart disease (CHD) is a type of heart disease where the lumina of the major arteries of the heart (coronary arteries) are narrowed by a build-up of plaque with a resultant limitation of blood flow to and oxygenation of the heart. Coronary heart disease can pose a diagnostic challenge in diabetic subjects due to the fact that it is often asymptomatic with a resultant lack of overt clinical complaint by the patients. It is an important cause of diabetes-associated morbidity and mortality and also a huge contributor to the cost of diabetes care.
Objective: To determine the association between CHD and age, sex, cigarette smoking, duration of diabetes, central obesity, glycaemic control, hypertension, chronic kidney disease (CKD), stroke, transient ischaemic attack (TIA), dyslipidaemia, lack of exercise and metabolic syndrome in type 2 diabetic subjects attending the diabetes outpatient clinic of Nnamdi Azikiwe University Teaching Hospital, Nnewi in South Eastern Nigeria.
Materials and Methods: This was a cross-sectional, observational study comprising 136 clinically stable T2DM subjects that were asymptomatic of coronary heart disease. The participants had two contacts with the researcher. Firstly, all the participants were evaluated with resting ECG for the diagnosis of CHD, 30 subjects had CHD while 106 had not. Next, the 30 subjects that had CHD and 98 of the 106 that had not, were met a second time on another clinic visit where medical history was extracted and anthropometric measurements were done. Next, biochemical tests, which included fasting blood glucose (FBG), glycated haemoglobin (HbA1c), fasting lipid profile (FLP) and serum creatinine were done and the glomerular filtration rate estimated using the Modification of Diet in Renal Disease (MDRD) calculator. Data were analyzed using the Statistical Package for Social Sciences (SPSS) version 25 (Chicago, IL, USA). The level of significance was set at p < 0.05.
Results: A total of 128 subjects completed the study and had their data analyzed. 30 subjects had CHD while 98 had not. There was significant association between CHD and TIA (p = 0.040), but no significant association between CHD and age (p = 0.959), sex (p = 0.679), educational status (p = 0.094), cigarette smoking (p = 1.000), duration of diabetes (p = 0.335), central obesity (p = 0.726), glycaemic control (p = 1.000), hypertension (p = 1.000), CKD (p = 0.570), stroke (p = 0.141), dyslipidaemia (p = 0.290), exercise (p = 0.641) and metabolic syndrome (p = 0.633) respectively among the subjects.
Conclusion: There was a high prevalence of asymptomatic CHD among stable type 2 diabetic subject and with the exception of TIA, there was no significant association between CHD and all the other risk factors for CHD that were studied, although these risk factors were found more among the subjects that had CHD compared with those that had not.
Keywords:
Associations; Asymptomatic; Coronary heart disease; Nigeria; Stable; Type 2 diabetes.
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