Treadmill Exercise Test Diagnostic Value Of Coronary Artery Disease In Patients With Diabetes Were Retrospectively Analyzed

Objective: Through performing comparative study on retrospective cases to observe the basic clinical conditions and the results of both the treadmill exercise test(“TET”)and the coronary angiography(“CAG”)for DM+ patients and DM- patients to explore the value for the use of TET in diagnosing coronary heart disease for diabetes patients, thus to provide and accumulate valuable clinical data for further improvement of the prevention for diabetes patients with coronary heart disease.Methods: Retrospectively collect 186 cases of patients who were initially diagnosed as having coronary heart disease in the Department of Cardiology of the First Affiliated Hospital of Medical College of Shihezi University as from January of 2009 to July of 2013. Those patients with relatively complete data had also been checked under TET and CAG during their hospitalization. Those cases are then subdivided into positive and negative groups based on their results of TET, which again re-subdivided into 2subgroups based on whether or not having diabetes, thus including the TET-DM-group, and TET-DM+group, TET+DM-group and TET+DM+ group. General conditions, the number of vessel disease in CAD cases and Gensini scores are compared between these cases. The sensitivity, specificity, positive predicative value, negative predicative value, rate of missed diagnosis, misdiagnosis rate and accuracy rate for detection of coronary heart disease, DM-patient and DM+patient using TET are analyzed in order to explore the value for the use of TET in diagnosing the coronary heart disease for DM patients.Results:1.The constituent ratio of hypertension among TET-DM-group, TET-DM+ group, TET+DM-group and TET+DM+group are compared and find the difference between TET-DM-group and TET-DM+group(P<0.05), and the difference TET-DM-group and TET+DM+ group(P<0.05)are of statistical significance, except that, constituent ratio of age and gender, smokers, BMI, TG, TC, HDL-C, LDL-C,Apo A, Cr and UA are of no statistical significance as P>0.05. 2.The number of vessel disease in CAD cases and the Gensini scores for the four groups are also on the incremental increase. Not all the number of vessel disease in CAD cases and Gensini scores are the same among the four groups of patients,P<0.05. It is concluded from comparison between each two groups that the number of vessel disease in CAD cases and Gensini scores between TET-DM-group and TET+DM-group, TET-DM-group and TET+DM+group,TET-DM+group and TET+DM+group, TET+DM-group and TET+DM+group are all of statistical significance.3.The percentage of coronary heart disease in TET-DM-group, TET-DM+group,TET+DM-group, and TET+DM+group accounts for 36.9%, 41.7%, 52.7% and 72.7% respectively,showing a consecutive uprising trend, therefore the difference of the number of vessel disease in CAD cases between the four groups of patients are of statistical significance(P<0.05), TET + DM + group, the largest number of patients with coronary heart disease and more for coronary multivessel disease. 4. The percentage of TET+ patients in groups with vessel disease in CAD cases accounts 50%, 52.5%, 55.6% and93.8% for zero, single, double, multiple vessel diseases group respectively, showing a consecutive uprising trend, therefore the difference of the number of TET+ cases among each vessel disease group is of statistical significance(P<0.05). From the comparison between each two groups, it can be concluded that the differences between zero and multiple vessel diseases groups, single and multiple vessel diseases groups, double and multiple vessel diseases groups, are all of statistical significance. The numbers of DM+cases among different vessel disease groups are of no statistical significance. 5. TET positive predictive diagnostic value of DM- patients with coronary heart disease 52.7%,TET positive predictive diagnosis of coronary artery disease in DM+ patients is 72.2%;the results of coronary artery disease diagnosis using CAG as the gold standard, TET diagnosis of coronary heart disease in DM+ patients positive predictive value was significantly higher than DM- patients.Conclusion: 1. The vessel diseases in CAD found with DM+ patients are more visibly than those found with DM- patients, which also show a high positive rate of TET. A TET check performed as early as possible is of significant importance to the timely detection, generation and development of such disease on DM + patients. 2. For TET test positive DM+ patients, the incidence rate of multiple vessel disease in CAD are high with relatively severe degree of coronary artery stenosis. Therefore the TET has a certain value in diagnosing the multiple vessel disease in CAD found with DM+ patients. 3.Combined with the patient’s medical history, exclude the interference of the disease and other factors into consideration,standardized operation, can improve the clinical value of TET.