The term “ischemic heart disease” describes a condition in which there is an inadequate supply of blood and oxygen to a portion of the myocardium; it typically occurs when there is an imbalance between myocardial oxygen supply and demand. The most common cause of myocardial ischaemia is atherosclerotic disease of epicardial coronary arteries. The Indian subcontinent is no exception to this epidemiological transition. Indians have three times higher risks of developing Coronary artery disease (CAD) as compared to Chinese and are twenty times more likely to die due to CAD compared to Asians and white South Africans. In India, 2.78 million deaths are due to CVD of which over 50% is due to CAD. It has been suggested that Indians have exaggerated insulin insensitivity in response to western lifestyle pattern that increases rates of Congestive Heart Disease (CHD) over stroke. In the present study one hundred patients of type 2 diabetes mellitus were evaluated in detail. After a through history and detailed clinical examination resting ECG was taken, patients with normal ECG pattern were further subjected to stress test and echocardiography for detection of latent coronary artery disease. The mean age of the study group was 56.11 years, males being 56.47 years and in females 55.68 years. The mean duration of diabetes mellitus was 8.66 years, males 8.95 years and in females being 8.23 years. The mean fasting blood sugar and post prandial blood sugar in the study group was 190.36 mg% and 262.78 mg% respectively. 41 out of 100 patients had ischemic heart disease, with a male to female ratio of 1.067: 1. Out of 25 patients with myocardial infarction 9 patients (36%) had atypical or silent myocardial infarction which was detected by routine ECG recording. 9 patients out of 25 patients of myocardial infarction died within one week of admission, immediate mortality being 36%. Four out of 100 patients (4%) had evidence of dilated diabetic cardiomyopathy. The predominant microvascular complications observed in the present study was retinopathy 46%, Nephropathy 11% and neuropathy 14%. Hypertension was observed seen in 43% of the patients and the incidence of IHD was higher among this group (68.3. Incidence of IHD among the smokers was 47.1. The mean BMI of males and females in the study group was 23.27 and 22.52 respectively. Incidence of IHD in patients with BMI > 25 was 23.8% , negatively significant association (p = 0.072). The mean total cholesterol LDL cholesterol HDL cholesterol and triglyceride level in the present study was 208.08 mg%, 117.88 mg%, 40.67 mg% and 163.65 mg% respectively. Mean total cholesterol, LDL Cholesterol and triglyceride were higher in patients with CAD and HDL Cholesterol was lower in patients with CAD, when compared with patients without CAD, which is statistically significant. Therefore the above mentioned factors are risk factors for CAD in patients with type 2 diabetes mellitus.
