Duke Treadmill Score Predicts Coronary Artery Disease Severity in Diabetics and Non-Diabetics

Coronary artery disease (CAD) is a significant cause of mortality and morbidity on a global scale. The Duke Treadmill Score (DTS) is a clinical evaluation that uses exercise stress testing to determine the severity of coronary artery disease (CAD). Objective: This study was to see how well DTS predicted the severity of CAD in diabetic and non-diabetic individuals. Methods: A prospective cohort study was conducted in the Department of Cardiology, PIMS, Islamabad, from March 2023 to September 2023. Total 450 patients were separated into diabetes (225) and non-diabetic (225) groups. Diabetes was diagnosed using American Diabetes Association criteria. The validated DTS scores exercise duration, ST-segment deviation, and angina symptoms to predict severe CAD. -11 or above is high risk, -10 to +4 is moderate, and +5 or more is low risk. Results: A study of 450 patients comprised 282 (62.6%) male and 168 (37.3%) female, with an average age of 58.4±13.2years. On coronary angiography, 170 diabetics (75.6%) and 130 non-diabetics (57.8%) had substantial CAD. Hypertension was 52.9% in diabetics and 49.3% in non-diabetics (p=0.920). Diabetics had 10.6% dyslipidemia and non-diabetics 9.3% (p=0.058). Conclusions: DTS may predict CAD severity in diabetics and non-diabetics, according to one study. Diabetes is a key risk factor for CAD, and DTS may aid in risk estimation. DTS findings and CAD risk assessment may potentially be affected by patient characteristics, exercise capacity, and treadmill technique.

To summarize the patient demographics and clinical features, descriptive statistics were utilized.Categorical data were presented as frequencies and percentages, whilst continuous variables were represented as means and standard deviations.Institutional Review Board (IRB) approved this study by securely storing anonymized patient data, con dentiality was maintained.Hypertension was 52.9% in diabetics and 49.3% in nondiabetics (p=0.920).As a risk factor, hypertension affects both populations signi cantly.Diabetes is a risk factor in diabetic individuals, with 29.7% is compared to 16.8% in non-diabetic group (p=0.018).Diabetes has long been linked to coronary artery disease, highlighting its role as a major risk factor.Dyslipidemia was 10.6% in diabetics and 9.3% in non-diabetics (p=0.058).Smoking was not signi cantly different between diabetics and non-diabetics, with 36.8% and 32.4% reporting smoking (p=0.753).Family history of CAD, which affected 7.5% of diabetics and 6.5% of nondiabetics, was not signi cantly different (p=0.425).Finally, 9.7% of diabetics and 3.6% of non-diabetics were obese (p=0.523)Table 2. Figure 1.  3.

D I S C U S S I O N
and discovered that up current smokers were more prevalent in the CAD group than the non-CAD group (68.2%, and 60.6% respectively) [18].Our results that the smoker with CAD group were 36.8% and non-CAD group was 32.4% patients with substantial coronary lesions are 45 years old and smokers or risk factors.Diabetes is a risk factor like coronary heart disease that requires speci c care.Diabetics have a greater rate of silent ischemia [19].According to research by [20] 35.3% of type 2 diabetic patients had high coronary risk was strongly associated with TC, (r = 0.695, p value < 0.000), match with our result that type 2 diabetic patients is 29.7%, and 16.8% with p value =0.018In diabetic and non-diabetic group respectively.Numerous studies have also shown a substantial correlation between diabetes and the development of large coronary lesions as well as the quantity of blood vessels affected [21].elevation acute coronary syndromes: large-scale observations from the CRUSADE (Can Rapid Risk Strati cation of Unstable Angina Patients Suppress Adverse Outcomes with early implementation of the American College of Cardiology/American Heart A s s o c i a t i o n G u i d e l i n e s ) n a t i o n a l q u a l i t y improvement initiative.Journal of the American College of Cardiology. 2005 Mar;45(6)

C O N C L U S I O N S
This research shows that DTS may predict CAD severity in diabetics and non-diabetics.Diabetes is a major CAD risk factor, and DTS may help estimate risk.Patient features, exercise ability, and treadmill technique may also affect DTS results and CAD risk assessment.

Table 1 :
Gender Distribution of Diabetic and Non-Diabetic patients.

Table 3 :
Clinical characteristics of DTS