Title: Evaluation of 24-Hour Ambulatory Electrocardiographic Recording in Detecting Asymptomatic Coronary Artery Disease in Diabetic Subjects
Abstract: In order to study the usefulness of ambulatory ECG recording in detecting asymptomatic coronary artery disease associated with diabetes mellitus, 136 diabetic subjects (type 1, n = 72; type 2, n = 64) were studied by 24-hour ECG monitoring. Positive test results on exercise electrocardiography and/or thallium scintigraphy with angiographically documented coronary artery disease served as a standard for significant coronary artery disease. Transient ST segment depressions were detected in 6 patients on 24-hour ECG recording. Seventeen diabetic subjects had ischemia on exercise electrocardiography and 31 on dynamic thallium scintigraphy. Twelve patients with evidence of myocardial ischemia in any of the noninvasive tests had significant (≥50% coronary artery narrowing) coronary artery disease, and insignificant (<50% coronary artery narrowing) coronary artery wall abnormalities were detected in 7 diabetic subjects; 6 refused coronary angiography. In the 6 subjects with a positive 24-hour ECG monitoring result, coronary angiography showed significant coronary artery lesions in 3 patients, insignificant coronary artery disease in 1 subject, and 2 had patent coronary arteries. Thus the sensitivity of the 24-hour monitoring was only 25%, the specificity 98% and the predictive accuracy 50%. These results show that ambulatory ECG recording is an insensitive method for detecting asymptomatic coronary artery disease in otherwise apparently healthy diabetic subjects.
Publication Year: 1990
Publication Date: 1990-01-01
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 2
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