An asymptomatic patient with T2DM has been shown 20–35% prevalence of silent CAD (SCAD), which could lead to myocardial ischemia, adverse cardiac events (ACE), and a poor prognosis outcome. Compared with nondiabetics, patients with type 2 diabetes mellitus (T2DM) have 2- to 4-fold increase risk of CAD and are more often without history and symptoms of coronary artery disease until the onset of myocardial infarction or sudden cardiac death. IntroductionĬoronary artery disease (CAD) is one of the leading causes of death and contributes to the adverse cardiovascular events.
Thus, screening for the first harmonic of the radial pulse may improve the risk stratification of cardiac events and SCAD in asymptomatic patients although they had no history of coronary artery disease or angina-related symptom. Survival analysis showed that C1 value is an independent predictor of ACE and SCAD in asymptomatic patients with T2DM. This study showed that C1 of the radial pulse wave is correlated with cardiovascular events. The hazard ratio and trend for cardiovascular-cause mortality were not significant. As C1 increased, the risk for composite ACE ( for trend) and for coronary disease ( for trend) also increased. By comparing the data of patients with C1 smaller than the first quartile and the patients with C1 greater than the third quartile, the hazard ratios were listed as follows: ACE (hazard ratio, 2.29 95% CI, 1.55–3.37), heart failure (hazard ratio, 2.22 95% CI, 1.21–4.09), myocardial infarction (hazard ratio, 2.44 95% CI, 1.51–3.93), left ventricular dysfunction (Hazard ratio, 2.01 95% CI, 0.86–4.70), and new symptoms and signs for coronary artery disease (hazard ratio, 2.03 95% CI, 1.45–2.84). The logrank test demonstrated that the cumulative incidence of ACE in patients with C1 above 0.96 was greater than that in those patients with C1 below 0.89 ( ).
Out of 1968 asymptomatic individuals with T2DM, ACE was detected in 239 (12%) of them during the follow-up period. The follow-up period lasted for 14.7 ± 3.5 months. Next, the new occurrence of ACE and the new symptoms and signs of coronary artery disease were recorded. First harmonic of the radial pressure wave, C1, was calculated. 1968 asymptomatic individuals with T2DM underwent radial pulse wave measurement. To measure the risk of SCAD in patients with T2DM and also to survey whether or not an increment of the first harmonic ( C1) of the radial pulse increases ACE. It is still unclear whether or not the first harmonics of the radial pulse spectrum is an early independent predictor of silent coronary artery disease (SCAD) and adverse cardiac events (ACE). It has been reported that harmonics of radial pulse is related to coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM).
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