ASYMPTOMATIC CORONARY-ARTERY-DISEASE IN DIABETES - RELATION TO COMMONRISK-FACTORS, LIPOPROTEINS, APOPROTEINS AND APO-E POLYMORPHISM

The risk factors for asymptomatic coronary artery disease (CAD) were e xamined in 138 diabetic patients. Following non-invasive screening exa minations (exercise electrocardiography, dynamic thallium scintigraphy , 24-h electrocardiographic recording), CAD was confirmed angiographic ally in 21 symptom-free diabetic subjects with an ischaemic finding in at least one of the non-invasive tests. The prevalence of asymptomati c CAD in this cohort of diabetic patients was 21/132 (16%), which may be an underestimation because 6 patients refused angiography. Risk fac tors (age, diabetes, smoking, hypertension, serum lipoproteins, apopro teins and apo E phenotypes) were analysed according to the presence or absence of CAD. Multivariate logistic stepwise analysis did not show any definite changes of serum lipids, lipoproteins and apoproteins in type 1 (n=72) and type 2 (n=66) diabetic patients with or without asym ptomatic CAD. The only factors associated with asymptomatic CAD were t he duration of diabetes (P<0.005) and the age of the patient (P<0.05). These results suggest that in diabetic patients the major risk factor for premature coronary atherosclerosis is diabetes itself. Assessment of other risk factors does not seem to define any subgroup with asymp tomatic CAD.